关节镜下治疗肩袖钙化性肌腱炎的临床疗效研究  

Clinical outcome of arthroscopic treatment for calcifying tendinitis of rotator cuff

作　　者：陈康[1] 陆伟[1] 朱伟民[1] 欧阳侃[1] 彭亮权[1] 柳海峰[1] 李皓[1] 冯文哲[1] 李瑛[1] 许鉴 钟名金 CHEN Kang;LU Wei;ZHU Weimin;OUYANG Kan;PENG Liangquan;LIU Haifeng;LI Hao;FENG Wenzhe;LI Ying;XU Jian;ZHONG Mingjin(Department of Sport Medicine,the First Affiliated Hospital of Shenzhen University,Shenzhen 2nd People＇s Hospital,Shenzhen 518000,Guangdong,China)

机构地区：[1]深圳大学第一附属医院深圳市第二人民医院运动医学科,广东深圳518000

出　　处：《中华骨与关节外科杂志》2018年第10期776-779,共4页Chinese Journal of Bone and Joint Surgery

基　　金：国家自然科学基金面上项目(81672234);深圳市卫计委项目(201606018)

摘　　要：背景:钙化性肌腱炎是导致肩节疼痛的常见疾病之一,易造成活动受限,严重影响生活质量。目的:探讨关节镜下治疗肩袖钙化性肌腱炎的治疗效果。方法:回顾性分析2010年1月至2015年10月行关节镜手术治疗的43例肩袖钙化性肌腱炎患者的病例资料。男18例,女25例;年龄40～78岁,平均(56±7.2)岁;右肩27例,左肩16例;钙化灶位于肩袖表面19例,冈上肌腱内13例,冈上、冈下肌腱交界7例,冈下肌腱内4例。所有患者均采用视觉模拟评分法(visual analogue scale, VAS)疼痛评分、 Constant-Murley评分、美国肩与肘协会(American Shoulder and Elbow Surgeon,ASES)评分及X线、CT检查进行评估。结果:43例患者随访时间16～44个月,平均(22.3±6.9)个月。所有患者症状均得到明显改善。术前、术后(2周、4周、2个月及末次随访时)VAS评分、Constant-Murley评分、ASES评分比较差异均有统计学意义(P<0.05)。2例患者术后X线、CT检查提示仍残留部分钙化灶,但患者症状消失、功能良好。钙化灶分别于术后4、10个月消失。结论:关节镜下治疗肩袖钙化性肌腱炎,术后可取得满意效果,是一种安全有效的治疗方式。Background： Calcifying tendinitis is one of the common diseases that cause shoulder pain. It is easy to lead to limited activities and seriously affect the quality of life. Objective： To investigate the clinical outcome of arthroscopic treatment for calcifying tendinitis of the rotator cuff. Methods： A total of 43 patients with calcifying tendinitis of the rotator cuff treated by arthroscopic operation from February 2010 to October 2015 were enrolled in this retrospective study. There were 18 males and 25 females with a mean age of（56±7.2） years old（range,40-78 years）; 27 right shoulders and 16 left shoulders were involved. The calcification was located on the surface of the rotator in 19 patients, within the supraspinatus tendon in 13 patients, between supraspinatus and infraspinatus in 7 patients, and within the supraspinatus tendon in 4 patients. X-ray examination and CT scanning were performed before and after surgery. The shoulder function was evaluated by VAS pain score, Constant-Murley score and ASES scoring system before surgical treatment and during follow-up. Results： The mean follow-up period was（22.3±6.9） months（range,16—44 months）. The shoulder function was evidently improved in all the patients. There were significant differences in terms of VAS pain score, Constant-Murley score and ASES score before and after surgery（including 2 weeks, 4 weeks, and 2 months postoperatively, and the last follow-up, P〈0.05）. The radiographs and CT scan showed reservation of partially calcified deposit in 2 patients, but no preoperative symptoms recurred. The calcification disappeared at 4 and 10 months postoperatively, respectively. Conclusions： Arthroscopic treatment can achieve satisfactory postoperative results for calcifying tendinitis of the rotator cuff. It is a safe and effective treatment for this disease.

关 键 词：钙化性肌腱炎 肩袖 关节镜 

分 类 号：R687.4[医药卫生—骨科学]