肩峰下滑囊切除在肩峰下撞击综合征手术治疗中的应用价值  

Value of bursectomy in the surgical treatments of shoulder impingement syndrome

作　　者：眭杰[1] 汪滋民[2] 

机构地区：[1]解放军第102医院手足外科,江苏常州213003 [2]第二军医大学长海医院骨科,上海200433

出　　处：《中国矫形外科杂志》2013年第1期37-40,共4页Orthopedic Journal of China

基　　金：上海市科委青年科技启明星项目资助(项目编号:08QA1400400)

摘　　要：[目的]探讨肩峰下滑囊切除在肩峰下撞击综合征手术治疗中的应用价值。[方法]自2007年7月～2010年12月,对45例肩峰下撞击综合征患者实施了ASD,21例行肩峰成形术,24例肩峰成形同时行肩峰下滑囊切除术,术后采用美国肩肘外科学会肩关节评分标准ASES Scale和加利福尼亚大学洛杉矶评分标准UCLA Scale评价两组患者肩关节疼痛及功能。[结果]ASES评分结果术后最终随访肩峰成形+肩峰下滑囊切除组(88.08±3.22)分,高于肩峰成形组(84.57±3.91)分,差异有统计学意义(P<0.05)。UCLA评分结果术后最终随访肩峰成形+肩峰下滑囊切除组(32.42±2.06)分,高于肩峰成形组(30.81±2.51),差异有统计学意义(P<0.05)。肩峰成形组中优4例,良15例,可2例,优良率为90.5%。肩峰成形+肩峰下滑囊切除组结果中优9例,良13例,可2例,优良率为91.7%。[结论]肩峰撞击综合征导致的SAB慢性炎症反应是引起患者肩痛及功能障碍的重要原因;在肩峰下减压术中必须广泛、彻底地切除肩峰下滑囊。[ Objective] To explore the value of bursectomy in the surgical treatments of shoulder impingement syndrome. [ Methods] Fortyfive patients with subacromial impingement syndrome were operated with arthroscopic subaeromial decompression, including 21 cases operated with acromioplasty alone and 24 cases operated with both acromioplasty and bursectomy simultaneously. Value pain and fuction of shoulders were evaluated with ASES scale and UCLA scale after operation. [ Results ] The postoperative ASES score of bursectomy was （ 88.08 ± 3.22 ） , and was higher than the score of acromioplasty which was （ 84. 57 ±3.91 ） . The two figures has statistics difference （ P 〈 0. 05 ） . In UCLA score, The postoperative score of burseetomy was （32.42± 2. 06） , and was higher than the score of acromioplasty which was （30. 81 ± 2. 51 ） . The figures also had statistics difference （P 〈0. 05） . In cases operated with acromioplasty, 4 cases were excellent, 15 cases were good, 2 cases were fair and no case was poor. Excellent and good results rate was 90. 5%. In cases operated with both acromioplasty and bursectomy, 9 cases were excellent, 13 cases were good, 2 cases were fair. Excellent and good results rate was 91.7%. [ Conclusion] Chronic inflammation of subacromial bursa led by subacomial impingement syndrome is the most important cause of pain and dysfunction of patients. So it is necessary to resect subacromial bursa widely and thoroughly in arthroscopic subacromial decompression.

关 键 词：肩关节 肩峰下撞击综合征 肩峰下滑囊 

分 类 号：R687.3[医药卫生—骨科学]