Description for medicine or protocol of treatment in detail:
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I. Experimental group
This operation was performed by highly trained and experienced clinicians in the operating room to ensure safety and aseptic operation. Patients were required to fast and keep water for at least 6 hours before surgery. During the operation, patients continued oxygen inhalation at low flow rate (2-2.5L/min), intravenous infusion channels were opened, and patients' vital signs were monitored by ecg monitoring in real time.
(1) Brachial plexus anesthesia: the patient was placed in supine position with the head on the healthy side and a soft and thin pillow on the neck and shoulder to fully expose the anesthesia puncture site. After routine disinfection, the intermuscular groove formed by the sternocleidomastoid muscle and the anterior middle scalenus muscle was located under the guidance of ultrasound, which was used as the injection point. Ropivacaine 75mg/10ml+2% lidocaine 10ml were injected to block the brachial plexus nerve. 15-20min after full anesthesia, manual release was performed.
(2) Manipulation:
①the patient supine position, the operator in the patient side, the affected limb flexion upward to 180°, the operation process in hand side elbow, hand placed in the patient's axilla at the upper end of the humerus near the humerus head, in order to prevent shoulder dislocation, repeat three times, you can hear or feel the voice or feeling of adhesion release.
② Abduction of the patient's affected limb to 180°, also pay attention to protect the humeral head, to prevent dislocation, repeat three times.
③ The anterior flexion side shoulder joint 90°, elbow flexion, adduction side shoulder joint 45°, repeat three times, you can hear or feel the sound or feeling of adhesion release.
④ Extend the elbow at 45°, rotate the affected shoulder inside and outside, repeat three times.
⑤ The patient is in lateral decubitus position, with elbow flexion after extension, so that the patient's fingers can touch at least the shoulder blade on the healthy side, repeat three times. After the operation, the limb was fixed and protected.
Note: During the operation, pay attention to strengthen communication with the patient and pay close attention to the patient's vital signs. It should be handled gently to avoid possible complications such as fracture caused by improper operation. After release, ice can be applied to reduce bleeding and reduce swelling.
II. Control group
Celecoxib capsule (specification: 200mg/ tablet; Manufacturer: Pfizer Inc. National Drug approval word: J 20140072), the patient needs to take 1 pill orally once a day for 12 consecutive days without adjusting the dosage. If any discomfort occurs during the medication, the drug will be stopped. Other analgesic drugs shall not be used at the same time during the test.
III. Functional exercise
Both groups after treatment began, the first day to the patients with functional exercise for the first time in the unified strictly trained under the guidance of clinic doctors, until the patients and the accompanying family members are the right functional exercise method, accompanying family members can be related video recording, the early family member can assist and supervise the patients with functional exercise. Follow up patients regularly to ensure the standard and correctness of exercise posture. Specific methods are as follows:
①Climbing training: Patients facing the wall upright, feet apart, and shoulder are the same as wide, double foot toe against the wall, side before hand on the wall, along the wall slowly lift on hard, within the scope of the pain can afford, but by the healthy limb assistant limb gradually upward, or others behind in the patients with elevated risk of side shoulder blades to encourage lift on limb to limit position.
②Shoulder training: the affected elbow flexion, as far as possible on the chest wall, in the pain tolerance range, the healthy side of the hand gradually push the affected elbow, so that the affected hand on the healthy side of the shoulder joint.
③Hand after pulling: the patient takes a sitting or upright position, the affected hand is placed behind the back, the palm is backward, in the pain tolerance range, the affected limb gradually adduction, lifting, the healthy hand can pull the affected hand to help it reach the limit position.
Note: Repeat the above actions after the patient's pain is relieved. Three groups, three times a day.
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