穿肌腱修补与转为全层修补治疗肩袖关节侧部分损伤临床疗效和安全性的Meta分析  

Clinical curative effects and safety of transtendon repair versus complete repair of conversion to full-thickness tears for articular-sided partial-thickness rotator cuff tears:a meta-analysis

作　　者：李建 甄东 由慧娟 郭彩芬 Li Jian;Zhen Dong;You Huijuan;Guo Caifen(Department of Sports Medicine,Beijing Jishuitan Hospital-Guizhou Hospital(Guizhou Province Orthopedics Hospital),Guiyang 550014,Guizhou,China;Department of Urology,Affiliated Hospital of Guizhou Medical University,Guiyang 550007,Guizhou,China)

机构地区：[1]北京积水潭医院贵州医院(贵州省骨科医院)运动医学科,贵阳550014 [2]贵州医科大学附属医院泌尿外科,贵阳550001

出　　处：《中国现代手术学杂志》2023年第3期180-186,共7页Chinese Journal of Modern Operative Surgery

摘　　要：目的系统评价穿肌腱修补与转为全层修补治疗肩袖关节侧部分损伤的临床疗效和安全性。方法计算机检索PubMed、Embase、Cochrane Library、中国期刊全文数据库(CNKI)、万方数据库和中文科技期刊全文数据库(维普)自建库起至2022年3月收录的穿肌腱修补与转为全层修补治疗肩袖关节侧部分损伤的相关研究文献。由两位研究者独立进行文献筛选、资料提取和文献质量评价后,采用RevMan 5.4软件进行Meta分析。结果共纳入8篇文献共计389例患者,其中穿肌腱修补组194例,转为全层修补组195例。Meta分析结果显示,术后两组患者疼痛VAS评分、肩关节ASES评分、Constant评分、UCLA评分以及术后关节粘连、肩袖再撕裂率比较,差异均无统计学意义(MD=0.41,95%CI:-0.38~1.19,P=0.31;MD=0.98,95%CI:-0.59~2.54,P=0.22;MD=-0.68,95%CI:-2.21~0.86,P=0.39;MD=0.47,95%CI:-0.15~1.08,P=0.14;MD=1.13,95%CI:0.32~3.94,P=0.85;MD=0.39,95%CI:0.05~2.74,P=0.34)。结论穿肌腱修补与转为全层修补治疗肩袖关节侧部分损伤临床疗效和安全性相当,术者可结合自身关节镜技术及患者具体情况进行选择,其远期效果仍需进一步研究证实。Objective To assess the clinical curative effects and safety of transtendon repair and com-plete repair of conversion to full-thickness tears for treatment of articular-side partial-thickness rotator cuff tears(PTRCTs)systematically.Methods The clinical trials of articular-side PTRCTs treated by transtendon repair and complete repair following conversion to full-thickness tears before March 2022 were retrieved in the database of PubMed,Embase,Cochrane Library,CNKI,Wangfang Date and VIP.Two reviewers independently screened the literatures,extracted the date and evaluated quality of literatures.Meta-analysis was conducted by RevMan 5.4 software.Results A total of 389 patients were included in 8 literatures(194 cases of transtendon repair and 195 cases of complete repair of conversion to full-thickness tears).The results of meta-analysis demonstrated that there was no significant difference in VAS score,ASES score,Constant score and UCLA score of shoulder joint,and postoperative incidence of adhesive capsulitis and retear between the transtendon re-pair technique and complete repair technique of conversion to full-thickness tears after the surgery(MD=0.41,95%CI:-0.38~1.19,P=0.31;MD=0.98,95%CI:-0.59~2.54,P=0.22;MD=-0.68,95%CI:-2.21~0.86,P=0.39;MD=0.47,95%CI:-0.15~1.08,P=0.14;MD=1.13,95%CI:0.32~3.94,P=0.85;MD=0.39,95%CI:0.05~2.74,P=0.34).Conclusions Both techniques of transtendon re-pair and complete repair of conversion to full-thickness tears can achieve similar clinical effects and safety for articular-side PTRCTs,surgeons can choose any one of them based on own arthroscopy techniques and specific conditions of patients.However,the long-term outcome of them would be required to determine by further research.

关 键 词：肩袖部分损伤 关节侧损伤 穿肌腱修补 转为全层修补 META分析 

分 类 号：R687.4[医药卫生—骨科学]