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height="40" align="center" style="border-bottom:1px double #B7BBBE">文章來(lái)源：疼痛科作者：王雪飛發(fā)布時(shí)間：2024-10-22 18:37:22 訪問人數(shù)：<script src=/e/public/ViewClick/?classid=12&id=9879&addclick=1></script></td> </tr> <tr> <td height="15"></td> </tr> <tr> <td align="left" class="neirong"><p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><font face="宋體">肩周炎，全稱肩關(guān)節(jié)周圍炎，是一種肩關(guān)節(jié)囊及其周圍韌帶、肌腱和滑囊的慢性特異性炎癥。由于該病好發(fā)于</font><font face="宋體">50歲左右的中老年人，故又稱五十肩、凍結(jié)肩或肩凝癥。肩周炎的主要癥狀為肩關(guān)節(jié)疼痛和活動(dòng)受限，嚴(yán)重影響患者的日常生活和工作。</font></span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">一</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">、</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"> </span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">肩周炎</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">的</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">臨床表現(xiàn)</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">肩周炎的主要臨床表現(xiàn)包括：</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">肩部疼痛</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：疼痛可為鈍疼或刀割樣痛，夜間尤重，甚至痛醒，放射至前臂、手部、頸、背部，可因運(yùn)動(dòng)加重。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">活動(dòng)受限</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：以外展、上舉、內(nèi)旋外展更為明顯，病人多不能抬臂、洗臉或梳頭。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">怕冷</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：患者肩怕冷，不少患者終年用棉墊包肩，即使在夏天，肩部也不敢吹風(fēng)。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">壓痛</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：患者肩關(guān)節(jié)周圍可觸及明顯的壓痛點(diǎn)，壓痛點(diǎn)多在肱二頭肌長(zhǎng)頭肌腱溝處、肩峰下滑囊、岡上肌附著點(diǎn)等處。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">肌肉痙攣及萎縮</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：三角肌、岡上肌等肩周圍肌肉早期可出現(xiàn)痙攣，晚期可出現(xiàn)廢用性肌萎縮。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">二</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">、肩周炎的治療</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><font face="宋體">肩周炎的治療主要包括保守治療和手術(shù)治療兩大類。由于肩周炎具有自愈性，一般在</font><font face="宋體">6-24個(gè)月可完全自愈，但部分患者功能不能完全恢復(fù)，因此早期診治是關(guān)鍵。</font></span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">1. 保守治療</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">保守治療是肩周炎的首選方法，包括藥物治療、物理治療、功能鍛煉等。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">2.</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">藥物治療</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">外用藥物</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：如外用膏藥、正紅花油、按摩乳等，敷在患肩或涂在患肩并輔以按摩。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">口服藥物</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：消炎痛、炎痛喜康等西藥，用于減輕疼痛，為按摩和功能鍛煉創(chuàng)造條件。中藥如養(yǎng)血榮金丸、活血止痛散等也可用于內(nèi)服或熱敷，促進(jìn)血液循環(huán)，祛瘀止痛。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">關(guān)節(jié)腔注射</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">治療</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：在壓痛明顯、關(guān)節(jié)活動(dòng)障礙呈進(jìn)行性加重時(shí)，可在</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">肩關(guān)節(jié)腔做注射治療，起到快速止疼消炎的目的。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">3.</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">物理治療</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">熱敷</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：使用熱毛巾、熱水袋等熱敷患肩，促進(jìn)血液循環(huán)，緩解疼痛。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">4.</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">功能鍛煉</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">聳肩</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><font face="宋體">：雙手自然放置身體兩側(cè)，雙肩做向上、向下活動(dòng)；雙手手心向下，雙肩由后往前旋轉(zhuǎn)，再由前往后，各</font><font face="宋體">30次。</font></span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">內(nèi)收探肩</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">：健肘托住屈曲的患肘，內(nèi)收朝向健側(cè)肩部，逐漸上托觸摸健側(cè)肩胛骨。以本人耐受為度，逐漸增加動(dòng)作范圍。</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;">面壁爬墻</span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><font face="宋體">：面壁，用雙手或單手沿墻壁緩慢向上爬動(dòng)，使上肢盡量高舉，保留</font><font face="宋體">5-10秒，然后再緩緩向下回到原處，反復(fù)數(shù)次。</font></span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-indent:24.0000pt;mso-char-indent-count:2.0000;text-autospace:ideograph-numeric; mso-pagination:none;line-height:150%;"><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><font face="宋體">肩周炎是一種常見病、多發(fā)病，好發(fā)于</font><font face="宋體">50歲左右的中老年人。其病因復(fù)雜多樣，主要包括軟組織退行性病變、慢性勞損、外傷、肩外因素等。肩周炎的治療以保守治療為主，包括藥物治療、物理治療、功能鍛煉等。在康復(fù)期間，患者應(yīng)注意肩部防寒保暖、糾正不良姿勢(shì)、堅(jiān)持適度體育鍛煉等。通過早期診治和積極康復(fù)，絕大多數(shù)肩周炎患者可以恢復(fù)痊愈。</font></span><span style="mso-spacerun:'yes';font-family:宋體;line-height:150%; font-size:12.0000pt;mso-font-kerning:1.0000pt;"><o:p></o:p></span></p> <p> </p> <p> </p></td> </tr> <tr> <td height="35" align="left" class="neirong">上一篇：<a 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