双排缝合技术联合富血小板血浆在肩袖损伤中的疗效  

Clinical effect of double row suture technique combined with platelet-rich plasma for rotator cuff tear

作　　者：张军[1] 满家政 冯仕明[1] 马超[1] 王涛[1] ZHANG Jun;MAN Jiazheng;FENG Shiming;MA Chao;WANG Tao(Department of Orthopedics,Xuzhou Central Hospital Affiliated to Southeast University,Xuzhou 221009,China)

机构地区：[1]东南大学附属徐州市中心医院骨科,江苏徐州221009

出　　处：《实用医学杂志》2022年第16期2051-2055,共5页The Journal of Practical Medicine

基　　金：江苏省高层次卫生人才“六个一”工程(编号:LGY2020028)。

摘　　要：目的探讨关节镜下双排缝合技术联合富血小板血浆在治疗肩袖全层损伤中的临床疗效。方法回顾性分析我院2019年6月至2020年6月收治78例肩袖全层撕裂行关节镜下双排缝合患者,分为观察组39例(富血小板血浆),对照组39例(关节腔灌洗液);比较两组术前、术后3、6、12、18个月VAS疼痛评分;术前、术后6、12、18个月Constant、UCLA肩关节评分及术后12个月肩袖再撕裂情况。结果重复测量方差分析结果显示,两组VAS、Constant、UCLA评分存在时间效应、分组效应、交互效应,差异有统计学意义(P<0.05);术后3、6个月观察组VAS评分低于对照组,但术后12、18个月VAS评分差异无统计学意义(P>0.05);术后6、12个月观察组Constant、UCLA评分优于对照组(P<0.05),但术后18个月差异无统计学意义(P>0.05);术后12个月MRI结果显示:观察组再撕裂2例(撕裂率5.1%),对照组5例(撕裂率12.8%),差异无统计学意义(P>0.05)。结论关节镜下双排缝合联合富血小板血浆治疗肩袖撕裂安全性良好,短期内可明显减轻术后疼痛,加快肩关节功能恢复,临床疗效较为满意。Objective To determine the clinical efficacy of arthroscopic double row suture combined with platelet-rich plasma in the treatment of full-thickness rotator cuff tear.Methods A total of 78 patients with full-thickness rotator cuff tear who were admitted to our hospital from June 2019 to June 2020,and underwent arthroscopic double-row suture were retrospectively analyzed.All patients were assigned to observation group(plateletrich plasma,n=39)and control group(intra-articular lavage fluid=39).VAS scores before operation and at 3,6,12 and 18 months after operation,Constant and UCLA scores before operation and at 6,12 and 18 months after operation and rotator cuff re-tear at 12 months after operation were compared between the two groups.Results ANOVA for repeated measurement showed that there were temporal,grouping and interaction effects in the VAS,Constant and UCLA scores of the two groups,and the differences were statistically significant(P<0.05).VAS scores in observation group were lower than those in control group at 3 and 6 months after operation,but there was no significant difference at 12 and 18 months after operation(P>0.05).Constant and UCLA scores after operation were higher than those before operation.Constant and UCLA scores in observation group were better than those in control group at 6 and 12 months after operation,but there was no significant difference at 18 months after operation(P>0.05).At 12 months after operation,MRI results showed that there were 2 cases with re-tear in observation group(tear rate 5.1%)and 5 cases with re-tear in control group(tear rate 12.8%),and the differences were statistically significant(P>0.05).Conclusion Arthroscopic double row suture combined with platelet-rich plasma in the treatment of rotator cuff tears was safe,which could significantly reduce postoperative pain,and accelerate the recovery of shoulder joint function in a short time with satisfactory clinical outcomes.

关 键 词：肩袖损伤 双排缝合技术 富血小板血浆 

分 类 号：R457.2[医药卫生—治疗学]