关节镜下修复肩袖撕裂的临床疗效分析  

Clinical effect analysis of arthroscopy in repair of rotator cuff tears

作　　者：蒋胜波[1] 董跃福[1] 刘旭东[1] 

机构地区：[1]连云港市第一人民医院关节外科,江苏连云港222002

出　　处：《现代医药卫生》2013年第24期3694-3696,共3页Journal of Modern Medicine & Health

摘　　要：目的探讨和分析关节镜下修复肩袖撕裂的手术方法和临床疗效。方法选择2009年2月至2013年2月收治的26例肩袖撕裂患者，其中小切口组（12例）在关节镜辅助定位下做一3～4cm小切口，直视下修复肩袖：全关节镜组（14例）在全关节镜下修复肩袖。术后随访，观察患者愈合情况，并比较两组患者术前、术后美国肩肘外科医师（ASES）、美国加州大学洛杉矶分校（UCLA）肩关节功能评分变化和手术时间变化以判断疗效。结果患者手术切口均I期愈合，未发生感染、内固定物松动及肩袖再撕裂等并发症。26例患者均获随访，随访时间6～30个月。平均（16～3）个月。两组患者末次随访时肩关节ASES和UCLA评分均较术前显著改善，差异有统计学意义（P〈0．05）；末次随访时两组肩关节ASES和UCLA评分比较，差异无统计学意义（p〉0．05），但小切口组患者手术时间较全关节镜组明显缩短，平均缩短（21．00～2．00）min，差异有统计学意义（P〈0．05）。所有患者术后ASES、UCLA评分优良率分别为84．6％、80．8％。结论关节镜下治疗肩袖撕裂临床疗效满意，具有损伤小、肩关节功能恢复快等特点，但因随访时间有限，其远期疗效还需进一步随访观察。Objective To explore and analyze the surgery method and clinical results of arthroscopy in treating rotator cuff repair. Methods From February 2009 to February 2013,26 patients with rotator cuff repair were enrolled,including mini- incision group （n= 12） with 3-4 cm incision to repair rotator cuff with assistance location of arthroscopy, arthroscopy group （n= 14 ） repaired rotator cuff with arthroseopy. To observe the intertion status after post-operation follow-up,and compare the change of American Shoulder and Elbow Surgeons （ASES） score, University Of California Los Angeles （UCLA） score and time change of operation before and ＇,after treatment in the two groups to judge the curative effect. Results All incisions healed primarily, and no infection,loosening of internal fixation,and rotator cuff re-tear occurred. All the patients were available for follow-up from 6 months to 30 months with the average of 16±3 months. The score of ASES and UCLA at last follow-up in the two groups improved obviously than that before operation with statistically significant difference （P〈0.05）. The comparison between ASES score and UCLA score of last follow-up had no statistically significant difference （P〉0.05）, while the operation time in mini-incision group shortened prominently than that in arthroscopy group by an average of （21.00＋2.00） minutes with statistically significant difference（P〈0.05 ）. The good rate of ASES score and UCLA score of all patients was 84.6% and 80.8% respectively. Conclusion Arthroscopic rota- tor cuff repair can be considered an appropriate treatment option in treating rotator cuff tears, and it has advantages including minimal invasion, faster recovery time, however, long-term observation will be needed for further exploration.

关 键 词：肩 损伤 肩关节 关节镜检查 肩袖撕裂 修复 治疗结果 

分 类 号：R684[医药卫生—骨科学]