肩袖损伤合并腋神经损伤的治疗  

Treatment of rotator cuff tears combined with axillary nerve injury

作　　者：陈印忠 郭威 郭秀程 贾庆卫 CHEN Yin-zhong;GUO Wei;GUO Xiu-cheng;JIA Qing-wei(Department of Joint Surgery and Sports Medicine,The Second Affiliated Hospital,Shandong First Medical University,Taiwan 271000,China)

机构地区：[1]山东第一医科大学第二附属医院关节与运动医学科,山东泰安271000

出　　处：《中国矫形外科杂志》2021年第16期1516-1518,共3页Orthopedic Journal of China

基　　金：山东省医药卫生科技发展计划项目(编号:2018WS123);泰安市科技发展计划项目(编号:2018NS0135)。

摘　　要：[目的]探讨肩袖损伤合并腋神经损伤的临床治疗结果。[方法] 2013年7月—2016年6月,本科收治肩袖损伤合并臂丛损伤患者5例。其中,3例于关节镜下行肩袖修补术,2例肩袖损伤给予保守治疗,5例患者均给予营养神经、物理治疗。[结果] 3例患者均顺利完成手术,无神经血管损伤等严重并发症发生,术后切口均Ⅰ级甲等愈合、拆线出院。5例均获随访,随访时间16-20个月,平均(17.82±1.78)个月。4例患者肩关节功能明显恢复,1例有所改善。末次随访时,患者肩关节功能Malleet评分、VAS评分、臂丛功能评分较术前显著改善(P<0.05)。[结论]肩袖损伤合并臂丛损伤诊断较为困难,易漏诊和误诊,应引起重视;治疗时应在积极治疗肩袖损伤的同时行理疗及营养神经治疗,可获满意疗效。[Objective] To explore the treament outcomes of rotator cuff tear combined with axillary nerve injury. [Methods] From July2013 to June 2016, 5 patients with rotator cuff injury accompanied with axillary nerve injury were treated in our department. Among them,3 patients underwent arthroscopic rotator cuff repair, while the remaining 2 patients received conservative treatment, in addition, all the 5 patients were given nerve nutrition and physical therapy. [Results] The 3 patients had rotator cuff repaired successfully without serious complications such as neurovascular injury. The incisions got primary healing, and the sutures were removed at discharged in all the 3 patients. All 5 patients were followed up for 16-20 months, with an average of(17.82±1.78) months. At the latest follow-up, 4 patients achieved excellent shoulder functional recovery, whereas 1 patient got functional improvement in some extent. The Malleet score, VAS score and brachial plexus score were significantly improved at the latest follow-up compared with those before the operation(P<0.05).[Conclusion] The diagnosis of rotator cuff injury accompanied with brachial plexus injury is difficult, and usually misdiagnosed, which should be paid attention. The treatment involves surgery, physiotherapy and nerve nutritional therapy simultaneously, and satisfactory results might be expected.

关 键 词：肩袖损伤 腋神经损伤 关节镜 损伤机制 

分 类 号：R683.41[医药卫生—骨科学]