关节镜下双排单滑轮缝线桥治疗全层肩袖损伤的临床效果分析  

Clinical efficacy of arthroscopic double-row single-pulley suture bridge in the treatment of total rotator cuff injury

作　　者：杨军[1] 李志国 刘昭 邢更彦 Yang Jun;Li Zhiguo;Liu Zhao;Xing Gengyan(Department of Orthopedics,Third Medical Center of Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]解放军总医院第三医学中心骨科,北京100039

出　　处：《中国医刊》2022年第7期771-774,共4页Chinese Journal of Medicine

基　　金：国家自然科学基金面上项目(81873914)。

摘　　要：目的探讨关节镜下双排单滑轮缝线桥对大、中、小型全层肩袖损伤的临床治疗效果。方法选取2016年7月至2019年6月解放军总医院第三医学中心收治的全层肩袖损伤患者94例,根据关节镜下测量的撕裂范围分为大型组26例(3cm≤撕裂范围<5cm)、中型组35例(1cm≤撕裂范围<3cm)、小型组33例(撕裂范围<1cm),所有患者术中均采用双排单滑轮缝线桥固定。术后随访18~24个月,比较三组患者术前、术后1年及末次随访时的疼痛视觉模拟量表(visual analogue scale,VAS)评分、关节功能恢复情况,以及术后再撕裂的发生情况。结果三组患者术后1年及末次随访时的VAS评分明显低于术前,且末次随访时明显低于术后1年,而术后1年及末次随访时小型组的VAS评分明显低于中型组和大型组,且中型组明显低于大型组,差异均有显著性(P<0.05)。三组患者术后1年及末次随访时的肩关节功能明显优于术前,且末次随访时明显优于术后1年,而术后1年及末次随访时小型组的肩关节功能明显优于中型组和大型组,且中型组明显优于大型组,差异均有显著性(P<0.05)。小型组术后无再撕裂发生,中型组术后发生再撕裂1例(2.94%),大型组术后发生再撕裂4例(18.18%),中、小型组术后再撕裂发生率明显低于大型组,差异有显著性(P=0.01)。结论双排单滑轮缝线桥对大、中、小型全层肩袖损伤均具有良好的治疗效果,但对于较大的肩袖损伤需延长功能康复期以防止再撕裂的发生。Objective Exploring the clinical efficacy of arthroscopic double-row single-pulley suture bridge for large,medium and small total rotator cuff injuries.Method Ninety-four patients with total rotator cuff injury admitted to the Third Medical Center of the PLA General Hospital from July 2016 to June 2019 were selected,The patients were divided into 26 cases in the large group(3cm≤tear<5cm),35 cases in the medium group(1cm≤tear<3cm),and 33 cases in the small group(tear<1cm)according to the extent of the tear measured arthroscopy,and all patients were fixed intra-operative with a double-row single-pulley suture bridge.The patients in the three groups were followed up for 18 to 24 months after surgery,and their pain visual analogue scale(VAS)scores,recovery of joint function,and the occurrence of postoperative re-tears were compared before surgery,one year after surgery,and at the last follow-up.Result The VAS scores of patients in the three groups were significantly lower at one year after surgery and at the last follow-up than before surgery,and significantly lower at the last follow-up than at one year after surgery,while the VAS scores of the small group were significantly lower than those of the medium and large groups at one year after surgery and at the last follow-up,and the medium group was significantly lower than the large group,and the differences were all significant(P<0.05).The shoulder function in the three groups was significantly better than that before surgery at one year after surgery and at the last follow-up,and significantly better at the last follow-up than at one year after surgery,while the shoulder function in the small group was significantly better than that in the medium group and the large group at one year after surgery and at the last follow-up,and the medium group was significantly better than the large group,and the differences were significant(P<0.05).No re-tears occurred in the small group,1 case(2.94%)in the medium group,and 4 cases(18.18%)in the large group.The incidence of re

关 键 词：肩关节镜 全层肩袖损伤 双排单滑轮缝线桥 损伤再撕裂 

分 类 号：R681.8[医药卫生—骨科学]