肩袖损伤修复中肱二头肌长头肌腱不同处理策略的疗效比较  

Comparison of the clinical outcomes of patients with different treatments for LHBT in arthroscopic rotator cuff repair

作　　者：杨晓[1] 胡豇[1] 王滋润[1] YANG Xiao;HU Jiang;WANG Zi run(Department of Orthopedics,Sichuan A cademy of Medical Sciences&Sichuan Provincial People's Hospital,Chengdu 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院骨科

出　　处：《实用医院临床杂志》2019年第6期34-36,共3页Practical Journal of Clinical Medicine

基　　金：四川省科技厅重点研发项目(编号:2019YFS0318);四川省人民医院高技术项目

摘　　要：目的探讨肱二头肌长头腱的不同处理策略对肩袖修复术后恢复的影响。方法81例行关节镜下肩袖修复的患者,根据治疗策略分为三组:对照组(单纯肩袖修复)23例,切断组(肩袖修复并肱二头肌长头腱切断术)30例,固定组(肩袖修复并肱二头肌长头腱切断后缝合固定术)28例。比较三组术前及随访期间的美国肩肘外科协会(ASES)、视觉模拟疼痛量表(VAS)、Constant-Murley肩关节功能评分。结果术后6月和9月,切断组的各项评分高于其他两组(P<0.05),术后1年及终末随访时,切断组和固定组的评分比较,差异无统计学意义(P>0.05),但均高于对照组(P<0.05)。结论关节镜下肩袖修复术中,采取肱二头肌长头腱切断或切断后缝合固定可明显降低患者术后疼痛,促进功能恢复。前者的术后疼痛恢复时间更短,但两者的远期临床疗效无明显差异。Objective To evaluate the effect of different treatment strategies for long head of biceps tendon(LHBT)on post operative recovery of rotator cuff(RC)repair.Methods Eighty one patients who underwent arthroscopic repair of rotator cuff were grouped into control group(n=23),tenotomy group(n=30)and tenodesis group(n=28)according to the surgery performed.The control group underwent RC repair alone.The tenotomy group underwent tenotomy of LHBT in RC repair and the tenodesis group under went tenodesis of LHBT in RC repair.The American Shoulder and Elbow Surgeons score(ASES),visual analog scale(VAS)and Con stant Murley score were compared among the three groups before operation and during the period of follow up.Results After 6 and 9 months of operation,the scores described above in the tenotomy group were higher than those in another two groups but there was no sig nificant difference in these scores between the tenotomy group and the tenodesis group after one year of operation(P>0.05).Howev er,the scores of the two groups were higher than those in the control group(P<0.05).Conclusion Tenotomy or tenodesis of LHBT in RC repair can obviously reduce the postoperative pain and improve the functional recovery.The recover time of tenotomy is much shorter than tenodesis.There are no significant differences in long term clinical outcomes between the two methods.

关 键 词：肩袖修复 肱二头肌长头肌腱 肌腱切断 肌腱缝合 

分 类 号：R685.4[医药卫生—骨科学]