肩痛疾病之二—肩峰撞擊癥
肩痛疾病之二-----肩峰下撞擊癥 肩袖組織位于肩峰與肱骨頭之間，并有滑囊保護。任何原因造成肩峰下方的空間狹窄或滑囊和肩袖及肌腱腫脹，在肩關(guān)節(jié)活動尤其上舉時，會造成肌腱、滑囊及骨組織的磨擦，產(chǎn)生炎癥和激惹，引起肩關(guān)節(jié)疼痛，活動障礙，即所謂肩關(guān)節(jié)撞擊綜合征。 A Patient's Guide To Shoulder Impingement Syndrome 肩關(guān)節(jié)撞擊綜合征病人指南 Shoulder impingement syndrome is a painful condition that results from wear and tear problems with the shoulder, or from performing repetitive overhead motions. 肩關(guān)節(jié)撞擊綜合征是因為肩關(guān)節(jié)磨損撕裂或反復做過頂動作而引起疼痛的一種疾病。 Shoulder impingement syndrome usually results from a muscle imbalance around the shoulder that places stress on the rotator cuff tendon. 肩關(guān)節(jié)撞擊綜合征往往由于肩關(guān)節(jié)周圍肌肉不平衡對肩袖產(chǎn)生壓迫而引起的。 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（一個充滿液體的囊袋，可潤滑肩袖，有利于流暢無痛的活動）往往在正常的生命過程中，因磨擦和受壓，引起退變，受到激惹或發(fā)生炎癥，就產(chǎn)生了這種情況。退變和炎癥會導致肌腱撕裂斷裂。作為肩關(guān)節(jié)撞擊綜合征的結(jié)果，稱為骨刺的贅生物會使骨頭下方容納肩袖的空間太小。肥厚的組織或其它結(jié)構(gòu)及力學的異常也會使這個空間變狹窄。 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. 肩關(guān)節(jié)撞擊綜合征會引起肩膀和上臂的疼痛，胳膊活動困難，當上舉或放下時感覺乏力和疼痛。夜間疼痛會干擾睡眠。 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. 有些病人通過避免某些活動，使用藥物及理療等治療后癥狀得以緩解。如果這些治療收效甚微或無效，推薦進行關(guān)節(jié)鏡下手術(shù)。 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. 關(guān)節(jié)鏡手術(shù)用關(guān)節(jié)鏡去除受損的肌腱組織和骨贅并進行重建。關(guān)節(jié)鏡是帶有攝像頭的細長設(shè)備，可以通過小切口插入到肩關(guān)節(jié)內(nèi)。外科醫(yī)生可以通過它觀察、診斷并治療肩關(guān)節(jié)疾病，不需要打開關(guān)節(jié)，干擾周圍組織。因為它是創(chuàng)傷很小，關(guān)節(jié)鏡手術(shù)降低了感染的風險，通常比傳統(tǒng)手術(shù)恢復期更短。 Let's take a look at arthroscopic shoulder surgery. 讓我們來看一看關(guān)節(jié)鏡下肩關(guān)節(jié)手術(shù)。 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，作幾個小切口。然后，用無菌生理鹽水擴張關(guān)節(jié)間隙。插入關(guān)節(jié)鏡，可以更改位置從不同的角度來觀察關(guān)節(jié)。修剪損傷的肌腱，用細長的手術(shù)器械將滑囊和骨刺去除。因為切口很小，所以只要簡單地縫合一針或用無菌創(chuàng)可貼拉合，最后再用繃帶包扎。 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. 術(shù)后，理療師首先會軟柔地幫您活動胳膊。然后您就可以逐漸進行力量強化練習。您的肩關(guān)節(jié)需要數(shù)周時間愈合?；謴蜁r間取決于病變的程度和手術(shù)的大小。您的醫(yī)生會告訴您預后如何。大多數(shù)肩關(guān)節(jié)撞擊綜合征的病人通過關(guān)節(jié)鏡手術(shù)獲得良好的結(jié)果。 （轉(zhuǎn)自胡伯文譯作）
朱芳兵 杭州市蕭山區(qū)中醫(yī)院 關(guān)節(jié)病?？?/span>
