肩关节镜下两种方法治疗肱二头肌长头肌腱炎的对比研究  

Comparison of two different arthroscopic techniques for long head of biceps tendinitis

作　　者：张波[1] 袁义[1] 章海均[1] 罗浩[1] 杨超[1] ZHANG Bo;YUAN Yi;ZHANG Hai-jun;LUO Hao;YANG Chao(Department of Orthopaedics,Ningbo No.2 Hospital,Ningbo 315010,Zhejiang,China)

机构地区：[1]宁波市第二医院骨科中心

出　　处：《中国骨伤》2019年第8期701-706,共6页China Journal of Orthopaedics and Traumatology

基　　金：宁波市科技惠民项目(编号:2016C51003)~~

摘　　要：目的:比较肩关节镜下肱二头肌长头肌腱单纯切断术与切断固定术治疗肱二头肌长头肌腱炎的临床疗效。方法:自2015年1月至2017年1月将40例肱二头肌长头肌腱炎患者根据不同手术方式分为单纯切断组和切断固定组。单纯切断组18例,其中男6例,女12例;年龄(62.2±6.1)岁;病程(8.5±2.2)个月。切断固定组22例,其中男8例,女14例;年龄(60.5±6.3)岁;病程(8.1±2.3)个月。比较两组患者的手术时间,并分别于术前及术后3、6、12个月采用VAS评分评价疼痛缓解程度,观察Popeye畸形发生例数,采用UCLA肩关节功能评分评价临床疗效。结果:40例患者获得随访,时间12~17(14.3±2.1)个月。单纯切断组8例术后出现Popeye畸形,切断固定组未出现Popeye畸形。单纯切断组手术时间(40.55±7.51)min,切断固定组(75.33±9.45)min,差异有统计学意义(P<0.05)。两组患者术后3、6、12个月VAS评分较术前下降,术后3个月单纯切断组VAS评分低于切断固定组(P<0.05),但术后6、12个月两组比较差异无统计学意义(P>0.05)。单纯切断组术组及切断固定组术后3、6、12个月UCLA评分较术前明显提高(P<0.05);术后3个月单纯切断组UCLA评分较切断固定组高(P<0.05),但术后6、12个月两组评分比较差异无统计学意义(P>0.05)。根据UCLA评分,单纯切断组优5例,良10例,差3例;切断固定组优8例,良12例,差2例;两组比较差异无统计学意义(χ^2=0.057,P=0.81)。结论:关节镜下肱二头肌长头肌腱单纯切断术与切断固定术对于肱二头肌长头肌腱炎的治疗均能获得良好的临床疗效,术后早期单纯切断术疗效优于切断固定术,晚期无显著性差异。Objective:To compare clinical efficacy of arthroscopic tenodesis and tenotomy in treating biceps long head tendinitis. Methods:From January 2015 to January 2017,40 patients with long head of the biceps tendinitis were randomly divided into tenotomy group(18 patients) and tenodesis group(22 patients). In tenotomy group,there were 6 males and 12 females with an average age of(62.2±6.1) yeas old,and the average course of disease was(8.5±2.2) months;while in tenodesis group,there were 8 males and 14 females with an average age of(60.5±6.3) years old,and the average course of disease was(8.1±2.3) months. Operative time and deformity of Popeye were compared between two groups,VAS score was used to evaluate degree of pain,and UCLA score was used to assess clinical effects before operation,3,6 and 12 months after operation. Results:Forty patients were followed up for 12 to 17 months with an average of(14.3±2.1) months. Eight patients occurred Popeye deformity in tenotomy group,and nobody in tenodesis group. There was significant difference between tenotomy group(40.55±7.51) min and tenodesis group(75.33±9.45) min. VAS score after operation at 3,6 and 12 months were decreased than that of before operation,and VAS score in tenotomy group was lower than that of in tenodesis group at 3 months after operation(P<0.05);while there were no difference in VAS score between two groups at 6 and 12 months after operation(P>0.05). UCLA score at at 3,6 and 12 months after operation in tenodesis group were increased than that of before operation,and UCLA score in tenotomy group was lower than that of in tenodesis group at 3 months after operation(P<0.05);while there were no difference in UCLA score between two groups at 6 and 12 months after operation(P>0.05). According to UCLA score,5 got excellent results,10 moderate and 3 poor in tenotomy group,while 8 got excellent results,12 moderate and 2 poor in tenodesis group,but without difference between two groups(χ~2=0.057,P=0.81). Conclusion:Both of arthroscopic tenotomy and tenode

关 键 词：关节镜 肘部肌腱病 腱切断术 

分 类 号：R685.4[医药卫生—骨科学]