肩峰成形术中肩峰成形尺度的影像学与临床疗效的对照研究  

Acromion plasty： a comparison between radiological measurements and clinical results

作　　者：吴旭东[1] 孙斌[1] 曾斌[1] 黄小刚[1] 明文义[1] 

机构地区：[1]舟山市中医骨伤联合医院骨科,浙江316000

出　　处：《中华手外科杂志》2015年第3期206-208,共3页Chinese Journal of Hand Surgery

摘　　要：目的 探讨关节镜下肩峰成形术治疗肩峰撞击综合征（shoulder impingement syndrome,SIS）的手术尺度和临床效果相关性,总结其临床应用价值.方法 收集我院自2008年8月至2014年8月肩峰撞击征经肩峰成形术患者67例,根据肩峰下缘到肱骨头软骨下皮质的最短距离（AHD）分为A组（术后AHD≥12 mm）和B组（术后7mm＜ AHD＜ 12 mm）,测量术前、术后0、3、6、12、24个月冈上肌出口位AHD值的大小;通过UCLA评分、VAS疼痛评分和Constant评分评估优良率.以期能凭借术前、术后的影像学对照与不同手术成形尺度后患者的临床疗效研究对照来确定治疗肩峰撞击综合征的手术成形的尺度.结果 67例患者中,A组的UCLA评分、VAS疼痛评分和Constant评分均优于B组,两者差异有统计学意义（P＜0.05）.结论 冈上肌出口位X线片能为SIS诊断提供重要依据,也是肩峰成形术中AHD的重要测量依据,术后AHD≥12 mm较之7mm＜ AHD＜ 12 mm更有利于患者的术后康复及肩关节功能的改善.Objective To explore the correlation between the extent of arthroscopic acromion plasty and the clinical results in treating shoulder impingement syndrome （SIS）,and summarize its clinical application value.Methods A retrospective review was conducted of 67 cases of SIS treated with acromion plasty between August 2008 and August 2014.These cases were divided into two groups based on the shortest distance from the acromion to the humeral head （AHD）：group A （postoperative AHD ≥ 12 mm） and group B （postoperative 7 mm〈 AHD〈 12 mm）.The AHD values were obtained pre-operatively and 0,3,6,12,24 months postoperatively at the supraspinatus muscle exit.The UCLA score,visual analog scale （VAS） of pain and Constant score were used to evaluate results.The pre-and post-operative radiological values were compared and the relation between the AHD values and clinical outcomes was analyzed to determine the extent of acromion plasty in treating SIS.Results Among the 67 cases the UCLA score,VAS and Constant score were all better in group A than in group B.The differences were statistically significant （P 〈 0.05）.Conclusion Supraspinatns muscle exit X-rays can provide important evidence for diagnosis of SIS as well as important measurements of AHD in acromion plasty.Acromion plasty achieving AHD≥ 12 mm leads to better postoperative rehabilitation and shoulder function improvement than that achieving 7 mm〈 AHD 〈 12 mm.

关 键 词：肩峰 关节镜 肩峰撞击综合征 肩峰成形术 

分 类 号：R684[医药卫生—骨科学]