超声引导下经皮穿刺介入治疗肩关节钙化性肌腱炎的短期疗效研究-现代医学

超声引导下经皮穿刺介入治疗肩关节钙化性肌腱炎的短期疗效研究

单位：南京中医药大学附属医院超声医学科, 江苏南京 210029

分类号：R684.7

出版年·卷·期（页码）：2026·54·第三期（492-496）

摘要：

目的：分析超声引导下经皮穿刺介入治疗肩关节钙化性肌腱炎的短期疗效。方法：对50例诊断为肩关节钙化性肌腱炎的患者行超声引导下穿刺介入治疗，并在治疗后1周、4周及4个月时进行随访。术前及术后随访均行肩关节常规超声和X线检查，同时对患者进行疼痛和肩关节功能评分(CMS)，观察超声和X线平片的病灶变化，结合临床体征评估疗效。结果：所有患者治疗后疼痛明显减轻，视觉模拟疼痛评分(VAS)显著降低，CMS明显提高，差异有统计学意义(P＜0.05)。治疗后1周，患者钙化灶范围即明显缩小，差异有统计学意义(P＜0.05)。术后病灶较术前超声主要表现为钙化灶回声减低，后方声影变淡，形态较前不规则，钙化周围组织水肿明显消退。相应的X线表现为病灶密度减低，范围缩小，边界不清。结论：超声引导穿刺介入治疗可实现肩关节钙化性肌腱炎的可视化治疗，显著缓解患者疼痛，改善患者的肩关节功能，疗效确切，值得临床推广。

Objective: To investigate the short-term efficacy of ultrasound-guided percutaneous interventional treatment for calcified tendinitis of the shoulder.Methods: A total of 50 patients diagnosed with calcified tendinitis of the shoulder underwent ultrasound-guided percutaneous interventional treatment and were followed up at 1 week, 4 weeks, and 4 months postoperatively. Preoperative and postoperative assessments included ultrasound and X-ray examinations, as well as pain and shoulder function scoring. Changes in lesions on ultrasound and X-ray images were observed, and therapeutic efficacy was evaluated in combination with clinical signs.Results: All patients experienced significant pain relief after treatment, with marked reduction in Visual Analogue Scale(VAS) score and significant improvement in the Constant-Murley Score(CMS) for shoulder function(P<0.05). The extent of calcific lesions significantly decreased as early as 1 week post-treatment(P<0.05). Postoperative ultrasound findings showed reduced echogenicity of the calcific lesions, diminished posterior acoustic shadow, irregular morphology and significant resolution of edema. Corresponding X-ray findings revealed reduced density, smaller extent and blurred boundaries of the lesions.Conclusion: Ultrasound-guided percutaneous interventional treatment provides a visualized approach for managing shoulder calcified tendinitis, significantly alleviating pain, improving shoulder joint functions, and achieving remarkable therapeutic effects. This technique is recommended for clinical application.

参考文献：

[1] HEGAZI T.Hydroxyapatite deposition disease:a comprehensive review of pathogenesis, radiological findings, and treatment strategies[J].Diagnostics, 2023, 13(16):2678.
[2] VERSTRAELEN F, BEMELMANS Y, LAMBERS HEERSPINK O, et al.Comparing midterm clinical outcome of surgical versus ultrasound guided needle aspiration of the calcific deposits for therapy resistant calcifying tendinitis of the shoulder.A comparative cohort study[J].J Orthop Sci, 2024, 29(3):802-808.
[3] OTA S, DELIMAR V, ŽAGAR I, et al.Efficacy of therapeutic ultrasound in the treatment of chronic calcific shoulder tendinitis:a randomized trial[J].Eur J Phys Rehabil Med, 2023, 59(1):75-84.
[4] MATKOVIA, GRGIM, TRKULJA I, et al.Association between osseous shoulder morphology and pathoanatomical characteristics of calcific deposits in rotator cuff calcific tendinitis[J].Diagnostics, 2025, 15(22):2908.
[5] SARAN S, BABHULKAR J A, GUPTA H, et al.Imaging of calcific tendinopathy:natural history, migration patterns, pitfalls, and management:a review[J].Br J Radiol, 2024, 97(1158):1099-1111.
[6] MOGGIO L, MAROTTA N, DE SIRE A, et al.Efficacy of conservative approaches on pain relief and function in patients with rotator cuff calcific tendinopathy:which is the best option? a systematic review and network meta-analysis[J].Orthop Surg, 2025, 17(11):3048-3066.
[7] SCONZA C, PALLONI V, LORUSSO D, et al.Ultrasound-guided percutaneous lavage for the treatment of rotator cuff calcific tendinopathy:a systematic review with meta-analysis of randomized controlled trials[J].Eur J Phys Rehabil Med, 2024, 60(6):995-1008.
[8] 邱贵兴.骨科学高级教程[M].北京:中华医学电子音像出版社, 2021:924.
[9] YANG W B, XU Q K, LIU X H, et al.Arthroscopic treatment of calcific tendinitis of gemellus superior and gemellus inferior:a case report and literature review[J].Orthop Surg, 2022, 14(3):621-627.
[10] VASSALOU E E, KLONTZAS M E, PLAGOU A P, et al.Ultrasound-guided percutaneous irrigation of calcific tendinopathy:redefining predictors of treatment outcome[J].Eur Radiol, 2021, 31(4):2634-2643.
[11] MOGGIO L, MERCURIO M, MAROTTA N, et al.Effectiveness of ultrasound-guided lavage for rotator cuff calcific tendinopathy:a case series study from a clinical and radiological perspective[J].J Clin Med, 2025, 14(15):5376.
[12] 明霞, 卞丽艳, 蒋逸秋, 等.关节镜下肩袖修复、松解术对肩袖损伤合并关节粘连患者肩关节功能的影响及危险因素分析[J].现代医学, 2024, 52(9):1398-1404.

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