肱二头肌长头肌腱止点重建联合滑车修复治疗滑车系统损伤的临床疗效  

The clinical effect of the long head of biceps tendon insertion reconstruction combined with pulley repair in the treatment of pulley system injuries

作　　者：向先祥 李瑞欣 刘佳 李春辉 魏志亨 弓爵 王卫明 Xiang Xianxiang;Li Ruixin;Liu Jia;Li Chunhui;Wei Zhiheng;Gong Jue;Wang Weiming(Department of Sports Medicine,Affiliated Xinhua Hospital of Dalian University,Dalian 116021,China)

机构地区：[1]大连大学附属新华医院运动医学科,大连116021

出　　处：《中华骨科杂志》2023年第11期759-767,共9页Chinese Journal of Orthopaedics

摘　　要：目的探讨肱二头肌长头肌腱(long head of biceps tendon,LHBT)止点重建联合滑车修复治疗滑车系统损伤的临床疗效。方法回顾性分析大连大学附属新华医院运动医学科2020年1至12月采用LHBT止点重建联合滑车修复治疗滑车系统损伤的患者46例(联合治疗组),男16例、女30例,年龄(51.3±5.7)岁(范围45~72岁);选择同期接受单纯LHBT止点重建的46例患者作为对照(单纯重建组),男14例、女32例,年龄(50.6±6.7)岁(范围46~70岁)。比较术前及术后1、3、6、12、24个月的肩关节疼痛视觉模拟评分(visual analogue scale,VAS)、Constant-Murley评分、美国肩肘外科协会(American Shoulder and Elbow Surgeon,ASES)评分及肱二头肌长头肌腱(long head of biceps tendon,LHB)评分。结果所有患者均获得随访,随访时间为(26.2±1.5)个月(范围24~27个月)。联合治疗组术后1、3、6个月时的VAS评分分别为(3.4±1.3)分、(2.0±1.1)分、(1.7±0.5)分,小于单纯重建组的(5.8±1.3)分、(3.5±1.1)分、(2.6±0.5)分,差异有统计学意义(P<0.05),而两组术后12、24个月时的差异无统计学意义(P>0.05)。联合治疗组术后1、3、6个月时的Constant-Murley评分分别为(31.3±4.7)分、(72.8±4.6)分、(89.1±5.4)分,大于单纯重建组的(21.5±6.8)分、(52.8±5.2)分、(80.1±6.2)分,差异有统计学意义(P<0.05),而两组术后12、24个月时的差异无统计学意义(P>0.05)。联合治疗组术后1、3个月时的ASES评分为(56.2±6.9)分、(82.7±8.2)分,大于单纯重建组的(40.2±5.6)分、(62.9±8.0)分,差异有统计学意义(P<0.05),而两组术后6、12、24个月时的差异无统计学意义(P>0.05)。联合治疗组术后6、12个月时的LHB评分为(70.1±5.4)分、(86.1±4.6)分,大于单纯重建组的(60.2±4.2)分、(70.2±5.8)分,差异有统计学意义(P<0.05),而两组术后24个月时的差异无统计学意义(P>0.05)。结论肩关节镜下LHBT止点重建联合滑车系统修复能减轻患者术后肩关节早期疼痛、改�Objective To investigate the clinical effect of long head of biceps tendon(LHBT)insertion reconstruction combined with pulley repair for pulley system injuries.Methods A total of 46 patients(combined treatment group)with pulley system injury treated with LHBT insertion reconstruction combined with pulley repair in the Sports Medicine Department,Affiliated Xinhua Hospital of Dalian University from January to December 2020 were retrospectively analyzed,including 16 males and 30 females,aged 51.3±5.7 years(range,45-72 years).46 patients who underwent simple LHBT insertion reconstruction during the same period were selected as the control group(simple reconstruction group),including 14 males and 32 females,aged 50.6±6.7 years(range,46-70 years).Visual analogue scale(VAS),Constant-Murley score,American Shoulder and Elbow Surgeon(ASES)score and long head of biceps tendon(LHB)score were compared preoperatively and at 1,3,6,12 and 24 months postoperatively.Results All patients were followed up for 26.2±1.5 months(range,24-27 months).The VAS scores of the combined treatment group at 1,3,and 6 months postoperatively were 3.4±1.3,2.0±1.1,and 1.7±0.5,respectively,which were significantly lower than those of the simple reconstruction group 5.8±1.3,3.5±1.1,and 2.6±0.5(P<0.05),while there was no significant difference between the two groups at 12 and 24 months postoperatively(P>0.05).The Constant-Murley scores of the combined treatment group at 1,3,and 6 months postoperatively were 31.3±4.7,72.8±4.6,and 89.1±5.4,respectively,which were statistically greater than those of the simple reconstruction group(21.5±6.8,52.8±5.2,and 80.1±6.2),and the differences were statistically significant(P<0.05),while there was no statistically significant difference between the two groups at 12 and 24 months postoperatively(P>0.05).The ASES scores of the combined treatment group at 1 and 3 months postoperatively were 56.2±6.9 and 82.7±8.2,which were statistically greater than those in the simple reconstruction group(40.2±5.6 and

关 键 词：肩关节 腱 关节镜检查 修复外科手术 

分 类 号：R687.4[医药卫生—骨科学]