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朱芳兵 三甲
朱芳兵 副主任医师
浙江中医药大学附属江南医院 关节病专科

肩痛疾病之二—肩峰撞击症

肩痛疾病之二-----肩峰下撞击症
肩袖组织位于肩峰与肱骨头之间,并有滑囊保护。任何原因造成肩峰下方的空间狭窄或滑囊和肩袖及肌腱肿胀,在肩关节活动尤其上举时,会造成肌腱、滑囊及骨组织的磨擦,产生炎症和激惹,引起肩关节疼痛,活动障碍,即所谓肩关节撞击综合征。


A Patient's Guide To Shoulder Impingement Syndrome
肩关节撞击综合征病人指南

Shoulder impingement syndrome is a painful condition that results from wear and tear problems with the shoulder, or from performing repetitive overhead motions.
  肩关节撞击综合征是因为肩关节磨损撕裂或反复做过顶动作而引起疼痛的一种疾病。

Shoulder impingement syndrome usually results from a muscle imbalance around the shoulder that places stress on the rotator cuff tendon.
  肩关节撞击综合征往往由于肩关节周围肌肉不平衡对肩袖产生压迫而引起的。

The condition develops when the tendons and bursa, a fluid filled sac, that lubricates the rotator cuff tendons, allowing smooth, painless motions, are rubbed and pinched, usually in the normal course of life, cause degeneration, irritation and inflammation. Degeneration and inflammation can cause tendons to tear or to detach. As a result of shoulder impingement syndrome, abnormal growth called bone spurs can make the space beneath the bone too samll for the rotator cuff tendons. The space may also become too narrow because of the thicken tissues or other structure or mechanical abnormalities.
  肌腱和滑囊(一个充满液体的囊袋,可润滑肩袖,有利于流畅无痛的活动)往往在正常的生命过程中,因磨擦和受压,引起退变,受到激惹或发生炎症,就产生了这种情况。退变和炎症会导致肌腱撕裂断裂。作为肩关节撞击综合征的结果,称为骨刺的赘生物会使骨头下方容纳肩袖的空间太小。肥厚的组织或其它结构及力学的异常也会使这个空间变狭窄。

Shoulder impingement syndrome causes pain in the shoulder and upper arm. You may have difficulty moving your arm. It may feel weak and painful when you raise or lower it. Night pain may interfere with your sleep.
  肩关节撞击综合征会引起肩膀和上臂的疼痛,胳膊活动困难,当上举或放下时感觉乏力和疼痛。夜间疼痛会干扰睡眠。

For some people, symptoms are relieved with avoiding of certain activities, medication, and therapy. Arthroscopic surgery is recommended when such treatment provide minimal or no improvement.
  有些病人通过避免某些活动,使用药物及理疗等治疗后症状得以缓解。如果这些治疗收效甚微或无效,推荐进行关节镜下手术。

Arthroscopic surgery uses an arthroscope to reconstruct or remove damaged tendons tissue and bone. An arthroscope is a thin instrument with a camera, that inserted into shoulder jointthrough small incisions. It allows surgeons to see, diagnose, and treat shoulder problems without opening up the joint or disrupting surrounding tissues. Because it is less invasive, arthroscopy has a decreased risk of infection and generally a shorter recovery period than traditional surgeries.
  关节镜手术用关节镜去除受损的肌腱组织和骨赘并进行重建。关节镜是带有摄像头的细长设备,可以通过小切口插入到肩关节内。外科医生可以通过它观察、诊断并治疗肩关节疾病,不需要打开关节,干扰周围组织。因为它是创伤很小,关节镜手术降低了感染的风险,通常比传统手术恢复期更短。

Let's take a look at arthroscopic shoulder surgery.
  让我们来看一看关节镜下肩关节手术。

To begin, several small incisions are made. Next, the joint space is expended with a sterile saline solution. The arthroscope is inserted. It may be repositioned to view the joint from different angle. Demaged tendon is trimmed, and bursa and bone spurs are removed with thin surgical instruments. Because the incisions are so small they simply require just a stitch or a sterile strip and are covered with a bandage.
  首先,作几个小切口。然后,用无菌生理盐水扩张关节间隙。插入关节镜,可以更改位置从不同的角度来观察关节。修剪损伤的肌腱,用细长的手术器械将滑囊和骨刺去除。因为切口很小,所以只要简单地缝合一针或用无菌创可贴拉合,最后再用绷带包扎。

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Following surgery, therapist will gently help you move your arm at first. And then you will progress to strengthening exercises. Your shoulder will need several weeks to heal. Your recovery will depend on the extent of your condition and the extent of the surgery that you had. Your doctor will let you know what to expect. Most people achieve good result with shoulder arthroscopy from impingement syndrome.
术后,理疗师首先会软柔地帮您活动胳膊。然后您就可以逐渐进行力量强化练习。您的肩关节需要数周时间愈合。恢复时间取决于病变的程度和手术的大小。您的医生会告诉您预后如何。大多数肩关节撞击综合征的病人通过关节镜手术获得良好的结果。
(转自胡伯文译作)

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朱芳兵 副主任医师
浙江中医药大学附属江南医院 关节病专科
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