8例肩关节急性疼痛性钙化性肌腱炎的关节镜治疗  

Arthroscopic treatment of acutely painful calcifying tendonitis of shoulder

作　　者：李忠[1] 杨洪彬[1] 叶里子[1] 王远辉[1] 王治[1] 鲁晓波[1] 戴刚[2] 杨柳[2] 

机构地区：[1]泸州医学院附属医院骨关节科,四川646000 [2]第三军医大学西南医院关节外科中心,重庆400038

出　　处：《重庆医学》2009年第23期2975-2977,共3页Chongqing medicine

基　　金：国家自然科学基金资助项目(30672200);四川省卫生厅科研课题资助项目(080180)

摘　　要：目的探讨关节镜治疗急性疼痛性肩关节钙化性肌腱炎的临床效果。方法8例保守治疗效果不满意的急性疼痛性肩袖钙化性肌腱炎患者根据Gartner放射学分类:Ⅰ型2例,Ⅱ型2例,Ⅲ型4例;所有病例采用关节镜下钙化沉积物清除术,其中2例加行肩峰成形术,在治疗前及术后行随访按Constant-Murley评分评估其疗效。结果6例术后钙化沉积物消失,Ⅱ型1例和Ⅲ型1例有钙化物残留。8例术后平均随访16.2个月,肩关节疼痛及活动明显改善,Constant-Murley评分术前平均为22.2分,术后平均为88.5分,差异有统计学意义(P<0.01)。结论关节镜下清除钙化沉积物具有疼痛缓解明显、关节功能恢复快、可同时处理肩关节内病变等优点,是保守治疗无效的急性疼痛性肩关节钙化性肌腱炎的有效治疗方法。Objective To evaluate the clinical results of arthroscopie treatment of acutely painful calcifying tendonitis of shoulder. Methods Eight patients with acutely pain of rotator cuff calcifying tendonitis of the shoulder werc evaluated according to the Gartner radiotogieal classification and revealed 2 cases of type Ⅰ deposits,2 cases of type Ⅱ and 4 cases of type Ⅲ deposits. All patients underwent arthroscopie resection of calcific deposits after failed conservative treatment via posterior approach. Three of them had additional acromioplasty. Constant-Murley score was adopted for evaluation before surgery and at the last follow up. Results Postoperative no calcific deposits were seen in 6 patients,1 case of type Ⅱ and 1 case of type Ⅲ deposits. The mcan follow up period was 16.2 months. There was greater improvement in the range of motion and pain relief of the shoulder. The average preoperative Constant-Murley score was 22. 2,and the average postoperative Constant-Murley score was 88. 5. Significant difference was found between preoperative and postoperative evaluation （P〈0.01）. Conclusion Arthroscopic resection of calcifie deposits shows promise for pain relief and functional restoration of calcific tendinitis with negligible complications. It is an effecuve method for the treatment of calcifying tendinitis after failed conservative treatment.

关 键 词：关节镜治疗 钙化性肌腱炎 肩关节 

分 类 号：R687.2[医药卫生—骨科学]