关节镜下钙化灶部分清理术治疗冈上肌腱钙化性肌腱炎  

Clinical analysis on arthroscopic incomplete removal of calcifications of supraspinatus tendinitis

作　　者：张旭腾 刘松波[1] 刘欣伟[1] 韩文锋[1] 张敬东[1] 郭超[1,2] 王百盛 刘海立 

机构地区：[1]沈阳军区总医院骨科全军重症战创伤救治中心,辽宁沈阳110016 [2]锦州医科大学研究生学院,辽宁锦州121001

出　　处：《局解手术学杂志》2018年第1期53-55,共3页Journal of Regional Anatomy and Operative Surgery

基　　金：辽宁省自然科学基金(20170540959)

摘　　要：目的评估关节镜下部分清除钙化灶并不予缝合肩袖治疗冈上肌腱化性肌腱炎的临床效果。方法回顾性分析2014年1月至2016年2月沈阳军区总医院收治的20例EllmanⅠ或Ⅱ级的冈上肌腱钙化性肌腱炎患者的临床资料,其中男4例,女16例;年龄45~62岁,平均(50.2±6.3)岁。20例患者均行手术治疗,术中对钙化灶均部分清除,并不予缝合肩袖。采用VAS疼痛评分、Constant-Murley评分、UCLA评分、X射线、CT评估术前及术后3、6、9个月的病情概况。结果 20例患者症状均明显减轻。VAS疼痛评分从术前(8.2±1.4)分至术后6个月(0.8±0.6)分、Constant-Murley评分从术前(44.6±7.4)分至术后6个月(95.4±3.4)分、UCLA评分从术前(12.2±3.6)分至术后6个月(33.1±1.4)分,差异均有统计学意义(P<0.05)。结论关节镜下部分清除钙化灶并不予肩袖缝合治疗冈上肌腱钙化性肌腱炎效果满意,医源性损伤小。Objective To evaluate the treatment effect of the arthroscopic incomplete removal of calcifications of the supraspinatus tendinitis without acromioplasty. Methods The clinical data of 20 patients of calcified supraspinatus tendinitis with EllmanⅠor Ⅱ in general hospital of Shenyang military area command from January 2014 to February 2016 were retrospectively analyzed. Of the 20 patients,4 males and 16 females,the age ranged from 45 to 62 years old,with average age（ 50. 2 ± 6. 3） years old. All the patients received removal incomplete of calcification without acromioplasty. Pre-and postoperative 3,6,9 months general situation were evaluated by the VAS score,Constant-Murley score,University of California Los Angeles（ UCLA） score,X-Radiographs and CT. Results The shoulder function was evidently improved in all 20 patients. The average VAS pain score was（ 8. 2 ± 1. 4） preoperatively and（ 0. 8 ± 0. 6） at the 6 months follow-up. The average Constant-Murley score was（ 44. 6 ± 7. 4） preoperatively and（ 95. 4 ± 3. 4） at the 6 months follow-up. The average UCLA score was（ 12. 2 ±3. 6） preoperatively and（ 33. 1 ± 1. 4） at the 6 months follow-up. Conclusion The arthroscopic incomplete removal of calcifications of the supraspinatus tendon without acromioplasty can lead to good results with less iatrogenic injury.

关 键 词：冈上肌腱钙化性肌腱炎 肩袖 关节镜 手术治疗 

分 类 号：R684.7[医药卫生—骨科学]