关节镜下治疗肩峰下撞击综合征合并肩袖撕裂  

Arthroscopic Acromioplasy and Rotator Cuff Repair for the Treatment of Subacromiai Impingement and Rotator Cuff Tear

作　　者：于晓兵[1,2] 赵德伟[1] 王卫明[1] 钟世镇[2] 刘宇鹏[1] 张耀[1] 

机构地区：[1]大连大学附属中山医院骨科,辽宁大连116001 [2]南方医科大学临床解剖学研究所,广州510515

出　　处：《中国临床解剖学杂志》2011年第3期346-349,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的报道肩峰下撞击综合征合并肩袖撕裂关节镜下肩峰减压成形术及肩袖修复的临床效果。方法自2007年始,对20例肩峰撞击征合并肩袖撕裂行关节镜下肩峰减压成形术及肩袖修复术,20例其中男8例,女12例,年龄25～72岁,16例无外伤史,4例有外伤史,均有肩关节疼痛伴有夜间痛、活动受限,Neer征阳性,疼痛反射弧阳性、撞击诱发试验阳性,术前MRI扫描示肩袖损伤,关节镜检查可见肩袖大撕裂10例,中撕裂6例,小撕裂4例,均行关节镜下肩峰下减压成形术,其中13例行缝合锚钉肩袖修复术,分别在术前及术后最终随访时采用ASES和Constant-Murley评分进行功能评估。结果术后随访24个月(10～32个月),ASES评分优良率为85%,Constant-Murley评分优良率为90%,术后各项评分均存在显著性差异(ASES:P<0.001,Constant-Murley:P<0.001)。结论肩峰下撞击综合征合并肩袖撕裂是肩关节疼痛和功能障碍的常见原因,关节镜下肩峰减压成形术及肩袖修复是治疗的有效方法,疗效确切。Objective To observe the clinical effects of arthroscopicacromiaoplasty and rotator cuff repair for treatment of Subacromiai Impingement and Rotator Cuff Tear.Methods from 2007,20 cases of Subacromiai Impingement and Rotator Cuff Tear,there were 8 male and 12 female,aged 25～72 years old,with an average of 45 years old.16 cases had nontraumatic history,and 4 cases had traumatic history.Patients had the symptoms of shoulder pain at night,and Restricted activities,positive Neer sign,positive pain arc and impact injection test.Preoperative MRI scans showed high signal in the rotator cuff in T2：10 cases with massive large rotator cuff tear,6 eases with middle tear,4 cases with small tear can be seen under the scope.They are treated with arthroscopic acromiaoplasty.13 cases of rotator cuff tears were repaired with suture anchor.In preoperative and final follow-up,shoulder ASES score and Constant-Mureley score were used for function evaluation.Results The follow-up of 24 months（10 to 32）months.The excellent and good rate of ASES score was 85%,the excellent and good rate of Constant-Murley score was 90%.Postoperative scores were significantly different（ASES：P0.001,t=11.343;Constant-Murley：P0.001,t=14.356）.Conclusion Subacromiai Impingement and Rotator Cuff Tear is the common casue of shoulder pain and dysfunction,which can be effectively treated with Arthroscopic Acromioplasy and Rotator Cuff Repair.

关 键 词：肩袖撕裂 肩峰下减压 修复术 关节镜 

分 类 号：R616.5[医药卫生—外科学]