关节镜下治疗原发性冻结肩的疗效及并发症风险分析  

Effect of Arthroscopic Treatment of Primary Frozen Shoulder and Risk of Complications

作　　者：吴常杰[1] 李英祥[1] 闫帮楷[1] 赵新动 李之红 冯小兵[1] WU Chang-jie;LI Ying-xiang;YAN Bang-kai;ZHAO Xin-dong;LI Zhi-hong;FENG Xiao-bing(Department of Orthopaedics,Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps,Changji 831800,Xinjang,China;Department of Anesthesiology,Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps,Changji 831800,Xinjang,China)

机构地区：[1]新疆生产建设兵团第六师奇台医院骨科,新疆昌吉831800 [2]新疆生产建设兵团第六师奇台医院麻醉科,新疆昌吉831800

出　　处：《医学信息》2021年第22期1-3,共3页Journal of Medical Information

基　　金：新疆生产建设兵团第六师五家渠市科技计划项目(编号:2014)。

摘　　要：目的评估关节镜下治疗原发性冻结肩的疗效,并分析相关的并发症风险。方法纳入2018年3月-2020年3月新疆生产建设兵团第六师奇台医院首诊的原发性冻结肩患者69例,采用随机数字表法分为对照组34例和手术组35例。对照组采用关节腔内注射糖皮质激素,手术组采用关节镜下切除肩关节腔内增生的炎性滑膜,松解肩袖间隙及相关韧带,两组术后均进行功能锻炼,并随访术前、术后1周、术后1、3、6个月、1年肩关节Neer评分,分析术后并发症发生的影响因素。结果手术组和对照组术后1周、1、3、6个月、1年Neer评分逐渐升高,差异有统计学意义(P<0.05);手术组和对照组术前Neer评分比较,差异无统计学意义(P>0.05);手术组术后1周、1、3、6个月、1年Neer评分均高于对照组,差异有统计学意义(P<0.05);手术组并发症发生率为17.14%,发生并发症患者年龄大于未发生并发症患者,病程长于未发生并发症患者,差异有统计学意义(P<0.05);两者性别、BMI、文化程度、吸烟史、患病部位比较,差异无统计学意义(P>0.05);多元线性回归分析显示,年龄是影响关节镜下治疗原发性冻结肩术后并发症的独立危险因素(P<0.05)。结论关节镜较传统方法治疗原发性冻结肩的疗效确切,但年龄较大患者更容易发生术后并发症,对于该高危人群应给予更多的关注。Objective To evaluate the efficacy of arthroscopic treatment of primary frozen shoulder and analyze the risk of related complications.Methods A total of 69 patients with primary frozen shoulder who were first diagnosed in Qitai Hospital of the Sixth Division of Xinjiang Production and Construction Corps from March 2018 to March 2020 were enrolled.They were divided into control group(34 cases)and operation group(35 cases)by random number table method.The control group was treated with intra-articular injection of glucocorticoid,and the operation group was treated with arthroscopic resection of the inflammatory synovial hyperplasia of the shoulder joint to release the rotator cuff space and related ligaments.Functional exercise was performed after operation in both groups.The Neer scores of the shoulder joint before operation,1 week after operation,1,3,6 months and 1 year after operation were followed up to analyze the influencing factors of postoperative complications.Results The Neer scores of the operation group and the control group increased gradually at 1 week,1 month,3 months,6 months and 1 year after operation,and the difference was statistically significant(P<0.05).The Neer scores at 1 week,1 month,3 months,6 months and 1 year after operation in the operation group were higher than those in the control group,and the difference was statistically significant(P<0.05).The incidence of complications in the operation group was 17.14%,the age of patients with complications was older than that of patients without complications,and the course of disease was longer than that of patients without complications,the difference was statistically significant(P<0.05);there was no statistically significant difference in gender,BMI,educational level,smoking history and disease location between the two groups(>0.05).Multivariate linear regression analysis showed that age was an independent risk factor for complications after arthroscopic treatment of primary frozen shoulder(<0.05).Conclusion Arthroscopy is more effective than

关 键 词：冻结肩 关节镜 糖皮质激素 炎性滑膜 

分 类 号：R684.3[医药卫生—骨科学]