老年肩峰撞击症合并全层肩袖损伤的关节镜下治疗分析  

Arthroscopic treatment of subacromial impingement syndrome in older patients with full-thickness rotator cuff tears

作　　者：潘峻 蔡友治 Pan Jun;Cai Youzhi(Department of Orthopedics,the First Affiliated Hospital of Zhejiang University,Hangzhou 310003,China)

机构地区：[1]浙江大学附属第一医院骨科,杭州310003

出　　处：《中华老年医学杂志》2020年第1期62-66,共5页Chinese Journal of Geriatrics

基　　金：浙江省自然科学基金一般项目(LY17H06003)。

摘　　要：目的探讨关节镜下肩峰成形术及肩袖修复治疗老年性全层肩袖损伤的临床疗效。方法前瞻性研究2013年1月至2017年12月,我院采用关节镜下肩峰成形术及肩袖修复或保守方法治疗老年性全层肩袖损伤患者共142例,根据患者治疗方法将其分为关节镜手术治疗组(手术组)和保守方法治疗组(对照组)。手术组完整随访70例,男26例,女44例;年龄66~83岁,平均74.5岁;参照DEORIO和COFIELD的分级标准,中撕裂61例,大撕裂9例。对照组完整随访62例,男27例,女35例;年龄65~82岁,平均74.2岁;参照DEORIO和COFIELD的分级标准,中撕裂41例,大撕裂21例。比较两组患者分组时、治疗1年后视觉模拟评分(VAS)、关节活动范围、简明肩关节功能测试(SST)评分、欧洲肩关节协会的Constant肩关节评分。结果132例患者获得至少1年的完整随访,手术组70例,对照组62例。分组时两组患者VAS评分、肩关节活动范围、SST评分、Constant评分组间差异无统计学意义(均P>0.05);随访1年时手术组患者的VAS评分、肩关节活动范围、SST评分和Constant评分均明显优于对照组(均P<0.05)。结论关节镜肩峰成形加肩袖修补治疗肩袖全层撕裂,可以明显改善患者肩关节功能,长期随访结果有待进一步研究。Objective To evaluate the clinical efficacy of arthroscopic acromioplasty and rotator cuff repair for older patients with full-thickness rotator cuff tears(RCTs).Methods This was a prospective cohort study.From January 2013 to December 2017,a total of 142 older patients with full-thickness RCTs were enrolled.Based on treatment methods,patients were divided into an arthroscopic rotator cuff repair group(operation group)and a conservative treatment group(control group).The operation group had 70 patients,including 26 males and 44 females,with an average age of 74.5 years(aged 66-83 years),and was followed up for≥12 months after surgery.The DEORIO and COFIELD criteria revealed 61 cases of medium tears and 9 cases of large tears in the operation group.The control group had 62 patients,including 27 males and 35 females,with an average age of 74.2 years(aged 65-82 years),and was followed up for≥12 months.There were 41 cases of medium tears and 21 cases of large tears,according to the DEORIO and COFIELD criteria.The visual analogue scale(VAS)scores,range of motion,Simple Shoulder Test(SST),Constant score were recorded pre-treatment and at 1-year post-treatment and compared between the two groups.Results 132 older patients(70 in the operation group and 62 in the control group)were followed up for at least 1 year.There was no significant differences in VAS scores,range of motion,SST scores and the Constant score pre-treatment between the two groups(all P>0.05).However,the operation group was associated with significantly improved VAS scores,range of motion,SST scores and the Constant score at 1-year post-treatment,compared with the control groups(all P<0.05).Conclusions Arthroscopic acromioplasty and rotator cuff repair can improve shoulder function in older patients with full-thickness RCTs.The long-term follow-up results will be studied further.

关 键 词：关节镜 肩痛 

分 类 号：R687[医药卫生—骨科学]