关节镜下肱二头肌长头腱切断术治疗中老年巨大肩袖撕裂患者的疗效观察  

Efficacy Observation of Arthroscopic Amputation of Long Head of Biceps Brachii Tendon in Middle-Aged andElderly Patients with Massive Rotator Cuff Tear

作　　者：李昂 史晨辉[1] 万国立 王维山[1] 石训达 蔡怡 Li Ang;Shi Chen-hui;Wan Guo-li;Wang Wei-shan;Shi Xun-da;Cai Yi(The First Affiliated Hospital of Shihezi University School of Medicine,Shihezi 832000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]石河子大学医学院第一附属医院,新疆石河子832000

出　　处：《中国社区医师》2023年第16期40-42,共3页Chinese Community Doctors

摘　　要：目的:探讨关节镜下肱二头肌长头腱(LHBT)切断术治疗中老年巨大肩袖撕裂(MRCT)患者的临床疗效。方法:选取2020年1月—2021年2月就诊于石河子大学医学院第一附属医院关节外科的中老年MRCT合并LHBT损伤患者49例为研究对象,根据治疗方式不同分为切断组(26例)和保留组(23例)。保留组给予单纯修复肩袖损伤治疗,切断组给予关节镜下LHBT切断术治疗。比较两组视觉模拟评分(VAS评分)、Constant-Murley肩关节评分、临床疗效、并发症发生率。结果:术后,两组VAS评分低于术前,且切断组低于保留组,差异有统计学意义(P<0.05)。术后,两组Constant-Murley肩关节评分高于术前,且切断组高于保留组,差异有统计学意义(P<0.05)。切断组总优良率高于保留组,差异有统计学意义(P=0.001)。切断组并发症发生率高于保留组,差异有统计学意义(P=0.002)。结论:关节镜下LHBT切断术治疗中老年MRCT患者的临床疗效显著,可缓解患者的疼痛程度,改善肩关节活动功能,但该手术会出现术后并发症,对于手臂外观要求较低的患者,可推荐该手术治疗。Objective:To investigate the clinical efficacy of long head of biceps brachii tendon(LHBT)amputation under arthroscope in the treatment of middle-aged and elderly patients with massive rotator cuff tear(MRCT).Methods:A total of 49 middle-aged and elderly patients with MRCT and LHBT injury admitted to the Department of Joint Surgery in the First Affiliated Hospital of Shihezi University School of Medicine from January 2020 to February 2021 were selected as the study subjects.According to the treatment mode,they were divided into amputation group(26 cases)and retention group(23 cases).The retention group was treated with the repair of rotator cuff injury alone,and the amputation group was treated with arthroscopic LHBT amputation.The visual analogue scale score(VAS score),Constant-Murley shoulder joint score,clinical efficacy,and complication rate were compared between the two groups.Results:After surgery,the VAS score in the two groups was lower than that before surgery,and the amputation group was lower than the retention group,and the difference was statistically significant(P<0.05).After surgery,the Constant-Murley shoulder joint score in the two group was higher than that before surgery,and the amputation group was higher than the retention group,and the difference was statistically significant(P<0.05).The overall excellent rate in the amputation group was higher than that in the retention group,and the difference was statistically significant(P=0.001).The incidence of complications in the amputation group was higher than that in the retention group,and the difference was statistically significant(P=0.002).Conclusion:Arthroscopic LHBT amputation has a significant clinical efficacy in the treatment of middle-aged and elderly patients with MRCT,which can relieve the pain level and improve the mobility of the shoulder joint,but this operation induces postoperative complications,and it can be recommended for patients with low arm appearance requirements.

关 键 词：肱二头肌长头腱切断术 巨大肩袖撕裂 关节镜 中老年 

分 类 号：R687.4[医药卫生—骨科学]