关节镜下大肩袖撕裂修补术后早期行积极被动活动锻炼的疗效观察  

作　　者：黄成龙[1] 陈刚[1] 徐红伟[1] 潘界恩[1] 蔡震海 吴华[1] 

机构地区：[1]嘉兴学院附属第二医院,314000

出　　处：《浙江临床医学》2020年第6期823-825,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省自然科学基金(LBQ20H060001);浙江省嘉兴市科技计划项目(2018AY32006)。

摘　　要：目的观察关节镜下单排修补大肩袖撕裂术后,早期进行积极被动活动锻炼对临床疗效的影响.方法选取关节镜下单排修补大肩袖撕裂患者92例,随机分为治疗组(n=45例)和对照组(n=47例),治疗组患者术后即进行积极被动活动锻炼,对照组术后只进行小范围被动活动锻炼.采用疼痛视觉模拟评分(VAS)、关节活动范围(ROM)、Constant评分对患者进行术前和术后的肩关节功能评定,并在术后12个月时行肩关节磁共振或超声检查,观察肩袖愈合情况.结果术前两组患者VAS评分、ROM及Constant评分和术后各时间点VAS评分差异无统计学意义(P>0.05);术后两组患者VAS评分和Constant评分均较术前有明显改善,术后3个月时,治疗组患者肩关节ROM和Constant评分均优于对照组(P<0.05),组间术后其余时间点比较,差异无统计学意义(P>0.05).术后12个月时,治疗组患者再撕裂率高于对照组(P<0.05).结论关节镜下单排修补大肩袖撕裂术后两组患者均取得了较好的临床疗效,早期行积极被动活动锻炼会增加术后再撕裂率,早期只进行小范围被动活动锻炼,不会影响肩关节功能恢复,而且有利于肩袖愈合.Objective To observe the clinical ffect of agresive early passive exercises afier arthroscopie single-tow repair for largs rotator cuff tear.Methods Ninety--two patients with large rotator cuf teas were treated with arthroscopic single-row repair,Postoperatively,patiens were randomized either to the treatment group with agresive early pasive exerciss of range of motion(ROM)or to a control group with limited passive exercises of ROM.Changes in the visual analogue scale(VAS)scorr,ROM and Constant scores were ssd preoperatively and postoperatvely.Repaitr integrity was determined using ulrasound or MRI at 12 months,.Results There wa no signifcant diference betwee the two gproups at baseline.The VAS score of the two groups at each time point postoperatively was signifcanly improved compared with that before surgery.ROM and Constant score in the treatment group improved more apidly than control group at 3 mooths postoperatively,there was no stistial sigpifcance between the two groups at 6 months,and 12 months after surgery.The reaere tate in the tretment group was higher than thar in the control group.Conclusion Pain.ROM,and Constant scores all signifcantly improved after arthroscopic single-row repair of lange rotator cuf tean.Postoperatively,agressive early pasive exercis may increase retear mnte。a linied early pasive exercses of ROM will be beuer for cuflt healing without discounting shoulder function.

关 键 词：关节镜 肩袖损伤 康复 

分 类 号：R68[医药卫生—骨科学]