肩袖损伤合并关节僵硬患者一期关节镜手术有效和安全性的系统评价  

A systematic review of the effectiveness and safety of one-stage arthroscopic surgery in patients with rotator cuff injury and joint stiffness

作　　者：钟礼伦 卢耀鸣 林志东 郭达[2] 徐逸生[2] 牛维[2] ZHONG Lilun;LU Yaoming;LIN Zhidong;GUO Da;XU Yisheng;NIU Wei(the Second Clinical Medical College of Guangzhou University of TCM,Guangzhou 510405,China;Guangdong Province Hospital of TCM,Guangzhou 510120,China)

机构地区：[1]广州中医药大学第二临床医学院,广州510405 [2]广东省中医院骨关节科,广州510120

出　　处：《上海医药》2021年第7期51-55,共5页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:系统评价一期关节镜手术对比二期手术治疗肩袖损伤合并关节僵硬的有效性及安全性。方法:通过计算机系统检索中国知网、万方资源数据、维普数据库、PubMed、Web of Science、The Cochrane Library和Embase数据库。查找相关的随机对照试验。进行文献质量评价并采用RevMan 5.3软件进行系统评价。结果:共纳入3篇研究,包括169例患者。由于纳入文献数量少且结局指标有差异,采用描述性系统评价。研究所纳入的3个研究显示末次随访时2组患者的关节活动度、美国肩肘外科协会评分量表(ASES)评分和视觉模拟量表(VAS)评分均较术前显著改善(P<0.05),且组间差异无统计学意义(P>0.05)。而在术后早期一期组活动度稍差于二期组。结论:一期手术组治疗肩袖损伤合并关节僵硬疗效确切,且与二期组相比,在末次随访时的活动度、ASES评分、VAS评分及肌力等方面无明显差异。然仍需要更多高质量研究来增强论证的强度。Objective:To systematically evaluate the effectiveness and safety of primary arthroscopic surgery versus secondary surgery for rotator cuff injury combined with joint stiffness.Methods:Databases of CNKI,Wanfang Resources,VIP,PubMed,Web of Science,The Cochrane Library and Embase was retrieved and relevant randomized controlled trials were searched.Perform literature quality assessment and systematic review using RevMan 5.3 software.Results:A total of 3 studies(169 patients)were included.Due to the lack of literature and differences in outcome indicators,descriptive systematic evaluation was used.Three studies included in the study showed that joint mobility,the American Shoulder and Elbow Surgeons form(ASES)score,and visual analogue scale(VAS)score of the two groups at the last follow-up were significantly improved than before surgery(P<0.05),and there were no significance differences between two groups(P>0.05).In the early postoperative period,the activity of the first-stage group was slightly worse than that of the second-stage group.Conclusion:The efficacy of the first-stage surgery group in treating rotator cuff injury with joint stiffness is clear,and there is no significant difference in activity,ASES score,VAS score,and muscle strength at the last follow-up compared with the second-stage group.At the same time,However,more high-quality studies are still needed to enhance the strength of the argument.

关 键 词：肩袖损伤 关节僵硬 一期手术 二期手术 系统评价 

分 类 号：R687.2[医药卫生—骨科学] R686.1[医药卫生—外科学]