肩袖撕裂后继发关节僵硬的影响因素初步分析  

Influencing factors for shoulder stiffness after rotator cuff tear

作　　者：关晨炜 徐丛[1] 王冰广 张健[1] 罗金伟 Guan Chenwei;Xu Cong;Wang Bingguang;Zhang Jian;Luo Jinwei(Department of Articular Surgery,Hospital Affiliated to Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院关节外科,承德067000

出　　处：《中华创伤骨科杂志》2022年第2期144-148,共5页Chinese Journal of Orthopaedic Trauma

基　　金：河北省教育厅在读研究生创新能力培养资助项目(CXZZSS2021139);河北省财政厅(2018年政府资助专科带头人培养项目)(361008);河北省卫生健康委科研基金项目重点科技研究计划(20190863)。

摘　　要：目的探讨肩袖撕裂患者继发肩关节僵硬的影响因素。方法回顾性分析2019年6月至2021年5月承德医学院附属医院关节外科经关节镜手术确诊为肩袖撕裂的228例患者资料。患者入院后即记录各基线资料,纳入肩关节僵硬可能的易感风险因素,依据肩关节被动活动度将其分组为僵硬组与非僵硬组。经单因素与多因素分析找出肩袖撕裂后继发关节僵硬的影响因素。结果初步单因素分析发现,高龄、吸烟史、有误诊史、无规范理疗史、高体重指数、长病程均可能是肩袖撕裂患者继发肩关节僵硬的易感风险因素(P<0.05);多因素分析证实,高龄(OR=1.474,95%CI:1.013~2.145,P=0.043)、吸烟史(OR=2.239,95%CI:1.147~4.368,P=0.018)、无规范理疗史(OR=0.167,95%CI:0.065~0.424,P<0.001)、高体重指数(OR=3.029,95%CI:1.657~5.536,P<0.001)、长病程(OR=1.775,95%CI:1.384~2.276,P<0.001)均是肩袖撕裂后继发肩关节僵硬的风险因素。结论高龄、吸烟史、无规范理疗史、高体重指数、长病程是肩袖撕裂患者并发肩关节僵硬的重要影响因素。Objective To study the influencing factors for shoulder stiffness after rotator cuff tear.Methods The data of 228 patients were retrospectively analyzed who had been diagnosed with rotator cuff tear by arthroscopic surgery at Department of Articular Surgery,Hospital Affiliated to Chengde Medical College from June 2019 to May 2021.Their baseline data were recorded immediately after admission,including possible risk factors for shoulder stiffness.The patients were divided into a stiffness group and a non-stiffness group based on passive range of motion of shoulder joint.Univariate and multivariate analyses were performed to find out the influencing factors for shoulder stiffness after rotator cuff tear.Results Preliminary univariate analysis showed that advanced age,smoking history,misdiagnosis history,no standardized physiotherapy history,high body mass index(BMI)and long duration of disease were all likely risk factors for shoulder stiffness in patients with rotator cuff tear(P<0.05).Multivariate analysis confirmed that advanced age(OR=1.474,95%CI:1.013~2.145,P=0.043),smoking history(OR=2.239,95%CI:1.147~4.368,P=0.018),no standardized physiotherapy history(OR=0.167,95%CI:0.065~0.424,P<0.001),high BMI(OR=3.029,95%CI:1.657~5.536,P<0.001)and long duration of disease(OR=1.775,95%CI:1.384~2.276,P<0.001)were the risk factors for shoulder stiffness.Conclusion Age>60 years,smoking history,misdiagnosis history,no standardized physiotherapy history,high body mass index and long course of disease may be the important influencing factors for shoulder stiffness after rotator cuff tear.

关 键 词：撕裂伤 肩关节 因素分析 统计学 肩关节僵硬 

分 类 号：R687.4[医药卫生—骨科学]