改良肩关节镜入路治疗肩胛下肌损伤的临床应用  

Clinical application of modified shoulder arthroscopy approach in treating subscapular muscle injury

作　　者：刘智[1] 毛矛 李刚[1] 闫惠鹏[1] 骆勇全[1] 胡仕其[1] 高春洪[1] 李建有[2] LIU Zhi;MAO Mao;LI Gang;YAN Huipeng;LUO Yongquan;HU Shiqi;GAO Chunhong;LI Jianyou(Department of Orthopedics,Pinghu Hospital of Traditional Chinese Medicine,Pinghu 314200,China;Department of Orthopedics,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]浙江省平湖市中医院骨科,浙江平湖314200 [2]浙江省湖州市中心医院骨科,浙江湖州313000

出　　处：《中国现代医生》2021年第13期84-87,共4页China Modern Doctor

基　　金：浙江省自然科学基金(LS19H060001)。

摘　　要：目的探讨改良关节镜入路在肩胛下肌损伤治疗中的应用。方法选择2016年1月至2019年12月我院收治的80例肩胛下肌损伤的患者,随机分为试验组和对照组两组,每组40例。对照组通过常规关节镜入路进行肩胛下肌损伤修补,试验组通过改良关节镜入路进行肩胛下肌损伤修补。术后两组均经过正规康复功能锻炼。比较两组患者手术时间、术后24 h疼痛视觉评分(VAS评分)、以及治疗前、治疗后半年患者ASES评分和UCLA评分。结果试验组手术时长(61.95±15.61)min,短于对照组手术时长(71.15±22.20)min,两组比较,差异有统计学意义(P<0.05)。试验组术后1 d VAS评分为(3.24±1.68)分,优于对照组评分(5.11±2.63),两组相比较,差异有统计学意义(P<0.05)。试验组术后半年ASES评分及UCLA评分分别为(82.05±3.30)分、(33.65±2.46)分,高于对照组ASES及UCLA评分(76.55±4.30)、(28.70±2.45),两组相比,差异有统计学意义(P<0.05)。结论改良关节镜入路对于肩胛下肌损伤修补具有手术时间短、患者疼痛轻、术中暴露更清楚、术后恢复快的优点,值得临床推广应用。Objective To explore the application of modified arthroscopy approach in the treatment of subscapular muscle injury.Methods A total of 80 patients with subscapular muscle injury admitted to our hospital from January 2016 to December 2019 were randomly divided into the experimental group and the control group,with 40 cases in each group.The control group used the conventional arthroscopic approach to repair the subscapular muscle injury,and the experimental group used the modified arthroscopic approach to repair the subscapular muscle injury.Both groups received formal rehabilitation exercises after the operation.The operation time,24 h visual pain score(VAS score)after surgery,ASES score and UCLA score before and six months after treatment were compared between the two groups.Results The operation time of the experimental group was(61.95±15.61)min,which was shorter than(71.15±22.20)min of the control group.The difference between the two groups was statistically significant(P<0.05).The VAS score of the experimental group was(3.24±1.68)one day after surgery,which was better than that(5.11±2.63)of the control group,and the difference between the two groups was statistically significant(P<0.05).The ASES score and UCLA score of the experimental group six months after surgery were(82.05±3.30)and(33.65±2.46),respectively,which were higher than those of the control group(76.55±4.30)and(28.70±2.45).The difference between the two groups was statistically significant(P<0.05).Conclusion The modified arthroscopic approach has the advantages of shorter operation time,less pain,clearer intraoperative exposure,and faster postoperative recovery for subscapular muscle injury repair.It is worthy of clinical application.

关 键 词：关节镜 手术入路 肩胛下肌 肩袖损伤 

分 类 号：R687[医药卫生—骨科学]