关节镜Bankart损伤修复术结合Remplissage术与单独开放性Bankart修复术治疗复发性肩关节前脱位的效果比较  

Comparison on the effect of Bankart arthroscopic repair combined with Remplissage and open Bankart alone in the treatment of recurrent anterior dislocation of shoulder joint

作　　者：何骁[1] 邓莉莉[1] He Xiao;Deng Lili(The First People’s Hospital of Chenzhou,Chenzhou,Hunan 423000,China)

机构地区：[1]郴州市第一人民医院,湖南郴州423000

出　　处：《感染．炎症．修复》2022年第4期213-216,共4页Infection Inflammation Repair

基　　金：湖南省郴州市运动医学技术研发中心项目资助[郴科发(2021)57号]。

摘　　要：目的:评价分别应用关节镜Bankart手术+Remplissage术与开放性Bankart修复术治疗Bankart损伤合并Hill-Sachs损伤的复发性肩关节前脱位的疗效。方法:86例Bankart损伤合并Hill-Sachs损伤的复发性肩关节前脱位患者纳入本研究,随机分为联合手术组及开放手术组。开放手术组(n=43例)行开放性Bankart修复术治疗,联合手术组(n=43例)行关节镜下Bankart手术并Remplissage手术治疗。观察两组患者的手术指标,用肩关节功能评分量表(Rowe评分)评估肩功能恢复程度,用视觉模拟评分(VAS)法评估两组患者的疼痛程度,比较并发症发生率。结果:联合手术组患者的手术切口[(3.91±0.67)cm]显著低于开放手术组[(14.65±1.29)cm],术中出血量[(11.40±2.74)mL]显著低于开放手术组[(45.69±15.39)mL],手术时间[(38.66±11.26)min]显著短于开放手术组[(85.67±18.72)min],住院时间[(9.85±1.37)d]显著短于开放手术组[(16.35±3.87)d,P<0.01]。术前,两组患者的VAS疼痛评分和Rowe评分组间比较差异无统计学意义(P>0.05);术后,联合手术组患者的VAS评分[(1.04±0.96)分]显著低于开放手术组[(2.64±1.41)分,P<0.001],Rowe评分[(71.88±7.41)分]显著高于开放手术组[(51.92±7.62)分,P<0.001]。联合手术组患者并发症总发生率(2.33%)明显低于开放手术组(20.93%,P<0.01);优良率(97.67%)明显高于开放手术组(76.74%,P<0.05)。结论:与开放性Bankart手术相比,Bankart损伤合并Hill-Sachs损伤的复发性肩关节前脱位患者应用关节镜Bankart+Remplissage术治疗后,患者机体受到的创伤较小,恢复时间更短,疼痛程度更轻,肩关节功能恢复更好,且并发症少,临床安全性高,疗效确切。Objective:To evaluate the efficacy of Bankart arthroscopic surgery+Remplissage and open Bankart repair for Bankart injury combined with Hill-Sachs recurrent anterior dislocation of shoulder joint.Methods:Eightysix patients with Bankart injury combined with Hill-Sachs recurrent anterior dislocation of shoulder joint were selected and included in this study.They were randomly divided into combined operation group and open operation group.The open operation group(n=43)underwent open Bankart repair,and the combined operation group(n=43)underwent arthroscopic Bankart operation and reimplissage surgery.The surgical indexes of the two groups were observed,and the shoulder function recovery degree was assessed by the shoulder Joint function scale(Rowe score),the pain degree was evaluated by visual analog scale(VSA),and the incidence of complications was compared.Results:The surgical incision[(3.91±0.67)cm]in the combined operation group was significantly lower than that in the open operation group[(14.65±1.29)cm].The intraoperative blood loss[(11.40±2.74)mL]was significantly lower than that in the open operation group[(45.69±15.39)mL].The operation time[(38.66±11.26)min]was significantly shorter than that in the open operation group[(85.67±18.72)min].And the hospital stay[(9.85±1.37)d]was significantly shorter than that in the open operation group(16.35±3.87d,P<0.01).Before surgery,there was no significant difference in the VAS pain score and Rowe score between the two groups(P>0.05).After surgery,the VAS score[(1.04±0.96)points]of the combined operation group was significantly lower than that in the open operation group[(2.64±1.41)points,P<0.001].The Rowe score[(71.88±7.41)points]was also significantly lower than in the open operation group[(51.92±7.62)points,P<0.001].The overall incidence of complications in the combined operation group(2.33%)was significantly lower than that in the open operation group(20.93%,P<0.01),and the excellent rate(97.67%)was significantly higher than that in the open operation gro

关 键 词：关节镜 BANKART损伤 Remplissage Hill-Sachs损伤 肩关节前脱位 复发性 

分 类 号：R687.4[医药卫生—骨科学] R687[医药卫生—外科学]