{"title":"冷冻肩关节加氢脱水的疗效:一项系统综述和荟萃分析。","authors":"Daryl Poku, Rifat Hassan, Filippo Migliorini, Nicola Maffulli","doi":"10.1093/bmb/ldad018","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>It is unclear whether hydrodilatation is beneficial in the management of frozen shoulder compared with other common conservative management modalities. This systematic review evaluates the efficacy of hydrodilatation for the management of frozen shoulder.</p><p><strong>Sources of data: </strong>A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An extensive search of PubMed, Embase, Scopus, Cochrane Central, Web of Science and CINAHL databases using multiple keyword combinations of 'shoulder', 'rotator', 'adhesive capsulitis', 'hydrodilatat*', 'distension' since inception of the databases to June 2023 was implemented.</p><p><strong>Areas of agreement: </strong>Hydrodilatation leads to at least transient more marked improvements in shoulder disability and passive external rotation compared with intra-articular corticosteroid injections.</p><p><strong>Areas of controversy: </strong>Hydrodilatation improves passive external rotation in the longer term. Moreover, hydrodilatation may be a preferable option over manipulation under anaesthesia, given its lower cost and better patient convenience.</p><p><strong>Growing points: </strong>Intensive mobilization after hydrodilatation is a promising adjuvant treatment option for patients suffering from a frozen shoulder.</p><p><strong>Areas timely for developing research: </strong>Although current evidence suggests that hydrodilatation provides a transient improvement in disability in patients with frozen shoulder, its clinical relevance remains unclear. 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引用次数: 0
摘要
引言:与其他常见的保守治疗方式相比,目前尚不清楚加氢脱水是否有益于冻肩的治疗。这篇系统综述评估了加氢脱水治疗肩周炎的疗效。数据来源:根据系统评价和荟萃分析的首选报告项目指南进行了系统评价。自数据库成立至2023年6月,我们使用“肩部”、“旋转体”、“粘连性囊炎”、“水水解物*”和“膨胀”的多个关键词组合对PubMed、Embase、Scopus、Cochrane Central、Web of Science和CINAHL数据库进行了广泛搜索。一致的领域:与关节内皮质类固醇注射相比,液压扩张至少能使肩部残疾和被动外旋得到短暂而显著的改善。争议领域:从长远来看,水力扩张改善了被动的外部旋转。此外,考虑到其较低的成本和更好的患者便利性,加氢脱水可能是比麻醉下操作更可取的选择。成长点:对于肩部冻结的患者来说,强化动员术是一种很有前途的辅助治疗选择。及时开展研究的领域:尽管目前的证据表明,加氢脱水可以暂时改善冻肩患者的残疾,但其临床相关性尚不清楚。有必要进一步研究,以确定其在病情管理中的作用。
Efficacy of hydrodilatation in frozen shoulder: a systematic review and meta-analysis.
Introduction: It is unclear whether hydrodilatation is beneficial in the management of frozen shoulder compared with other common conservative management modalities. This systematic review evaluates the efficacy of hydrodilatation for the management of frozen shoulder.
Sources of data: A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. An extensive search of PubMed, Embase, Scopus, Cochrane Central, Web of Science and CINAHL databases using multiple keyword combinations of 'shoulder', 'rotator', 'adhesive capsulitis', 'hydrodilatat*', 'distension' since inception of the databases to June 2023 was implemented.
Areas of agreement: Hydrodilatation leads to at least transient more marked improvements in shoulder disability and passive external rotation compared with intra-articular corticosteroid injections.
Areas of controversy: Hydrodilatation improves passive external rotation in the longer term. Moreover, hydrodilatation may be a preferable option over manipulation under anaesthesia, given its lower cost and better patient convenience.
Growing points: Intensive mobilization after hydrodilatation is a promising adjuvant treatment option for patients suffering from a frozen shoulder.
Areas timely for developing research: Although current evidence suggests that hydrodilatation provides a transient improvement in disability in patients with frozen shoulder, its clinical relevance remains unclear. Further research is necessary to establish its role in the management of the condition.
期刊介绍:
British Medical Bulletin is a multidisciplinary publication, which comprises high quality reviews aimed at generalist physicians, junior doctors, and medical students in both developed and developing countries.
Its key aims are to provide interpretations of growing points in medicine by trusted experts in the field, and to assist practitioners in incorporating not just evidence but new conceptual ways of thinking into their practice.