关节镜下两种技术治疗肩袖关节侧部分撕裂的疗效比较  

Efficacy comparison of two kinds of techniques foRtreatment of rotatoRcuff joint lateral partial teaRundeRarthroscopy

作　　者：李嘉[1] 赵红莲[1] 王智慧[1] 吴迪[1] 徐丛[1] LI Jia;ZHAO Hong-lian;WANG Zhi-hui;WU Di;XU Cong(Dept of Joint Surgery,the Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China)

机构地区：[1]承德医学院附属医院关节外科,河北承德067000

出　　处：《临床骨科杂志》2022年第4期527-531,共5页Journal of Clinical Orthopaedics

摘　　要：目的探讨关节镜下经肌腱修补术和转全层撕裂修补术治疗肩袖关节侧部分撕裂的临床疗效。方法将46例肩袖关节侧部分撕裂患者采用随机数字表法分为经肌腱修补组(采用经肌腱修补术,23例)和转全层修补组(采用转全层撕裂修补术,23例)。比较两组末次随访时疼痛VAS评分、UCLA评分、ASES评分、肩关节活动度以及术后恢复活动时间。结果患者均获得随访,时间12~22个月。术中及术后均无神经血管损伤、锚钉脱出及深部感染、肩关节功能明显受限等并发症发生。术后MRI和彩超复查肩袖肌腱再撕裂情况:转全层修补组发现2例,经肌腱修补组未发现。疼痛VAS评分、UCLA评分、ASES评分:末次随访时两组均较术前明显改善(P<0.05),两组间比较差异均无统计学意义(P>0.05)。末次随访时肩关节活动度两组比较差异均无统计学意义(P>0.05)。术后恢复日常活动时间转全层修补组早于经肌腱修补组(P<0.05)。结论关节镜下经肌腱修补术和转全层撕裂修补术治疗肩袖关节侧部分撕裂,均可显著改善患者肩关节功能,但经肌腱修补术的患者术后肩关节功能恢复较慢。Objective To investigate the clinical effect of transtendon repaiRand transfull-thickness teaRrepaiRfoRrotatoRcuff joint lateral partial tears undeRarthroscopy.Methods The 46 patients with rotatoRcuff joint lateral partial tears were divided into two groups according to the random numbeRtable method:transtendon repaiRgroup(transtendon repair,23 cases)and transfull-thickness teaRrepaiRgroup(transfull-thickness tear,23 cases).At the last follow-up,pain visual analogue score(VAS),UCLA score,ASES score,the range of motion of shouldeRand postoperative restoring activity time were compared between the two groups.Results All patients were followed up foR12~22 months.There were no complications such as neurovasculaRinjury,anchoRprolapse,deep infection and obvious limitation of shouldeRfunction during and afteRoperation.The rotatoRcuff tendon re-tears conditions were reexamined with postoperative MRI and coloRultrasound:there were 2 cases in the tansfull-thickness repaiRgroup,but none in the transtendon repaiRgroup.Pain VAS,UCLA score and ASES score:at the last follow-up,both groups were significantly improved than the preoperation(P<0.05);there were no significant differences between the two groups(P>0.05).There was no statistical significance in the range of motion of the shouldeRjoint between the two groups at the last follow-up(P>0.05).The time to restore daily activities afteRoperation in transfull-thickness repaiRgroup was earlieRthan that in transtendon repaiRgroup(P<0.05).Conclusions In the treatment of rotatoRcuff partial tear,both transtendon repaiRand transfull-thickness teaRrepaiRcan significantly improve shouldeRfunction,while the shouldeRjoint function is more slowly in the patients repaired with transtendon repaiRsurgery.

关 键 词：肩关节 关节镜检查 肩袖撕裂 部分撕裂 

分 类 号：R686.1[医药卫生—骨科学] R687.2[医药卫生—外科学] R687.4[医药卫生—临床医学]