肩关节镜辅助下TightRope钢板固定治疗肩锁关节脱位疗效及对患者术后免疫应激反应的影响  

Clinical Efficacy of Shoulder Arthroscopy-Assisted TightRope Plate Fixation in the Treatment of Acromioclavicular Joint Dislocation and Its Impact on Postoperative Immune Stress Response in Patients

作　　者：吴斯 程良礼 李贺伟[2] 刘志军 石峰 WU Si;CHENG Liangli(Daye People's Hospital,Hubei Daye 435100,China)

机构地区：[1]湖北省大冶市人民医院骨科,湖北大冶435100 [2]华中科技大学同济医学院附属梨园医院骨科,湖北武汉430000

出　　处：《河北医学》2023年第11期1905-1910,共6页Hebei Medicine

基　　金：湖北省自然科学基金,(编号:2019CFB683)。

摘　　要：目的:探究肩关节镜辅助下TightRope钢板固定治疗肩锁关节脱位的临床疗效及对患者术后免疫应激反应的影响。方法:选取2021年2月至2022年2月本院收治的100例肩锁关节脱位患者,根据手术方案分为A组(n=52)和B组(n=48),A组给予肩关节镜辅助下TightRope钢板固定治疗,B组给予肩关节镜辅助下锁骨钩钢板内固定治疗。比较两组临床疗效、肩关节功能[欧洲肩关节协会评分系统Constant肩关节评分]、免疫反应(CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比值)、应激反应[皮质醇(Cor)、促肾上腺皮质激素(ACTH)]及术后并发症。结果:相较于B组,A组优良率明显较高(P<0.05),治疗后6个月Constant肩关节各维度评分均明显较高(P<0.05),治疗后1d CD3^(+)、CD4^(+)、CD8^(+)、CD4^(+)/CD8^(+)比值下降幅度均明显较低(P<0.05),血清Cor、ACTH上升幅度均明显较低(P<0.05),术后并发症总发生率明显较低(P<0.05)。结论:针对肩锁关节脱位患者而言,肩关节镜辅助下TightRope钢板固定治疗可提高其临床优良率,促进肩关节功能的恢复,减轻对免疫应激反应,术后并发症也较少。Objective:To investigate the clinical efficacy of shoulder arthroscopy-assisted TightRope plate fixation in the treatment of acromioclavicular joint dislocation and its effect on postoperative immune stress.Methods:A total of 100 patients with acromioclavicular joint dislocation who were admitted to our hospital from February 2021 to February 2022 were selected and divided into group A(n=52)and group B(n=48)according to the surgical plan.Group A was given shoulder arthroscopy The patients were treated with TightRope plate fixation assisted,and group B was treated with shoulder arthroscopy-assisted clavicle hook plate internal fixation.The clinical efficacy,shoulder joint function[European Shoulder Association scoring system Constant shoulder joint score],immune response(CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)ratio),stress response[cortisol(Cor),adrenocorticotropic cortex hormone(ACTH)]and postoperative complications]were compared between the two groups.Results:Compared with group B,the excellent and good rate of group A was significantly higher(P<0.05),6 months after treatment,the scores of each dimension of Constant shoulder joint were significantly higher(P<0.05),and the decreasing range of CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+)ratio at 1 day after treatment was significantly lower(P<0.05).The increase rates of serum Cor and ACTH were significantly lower(P<0.05),and the total incidence of postoperative complications was significantly lower(P<0.05).Conclusion:For patients with acromioclavicular joint dislocation,shoulder arthroscopy-assisted TightRope plate fixation can improve the clinical excellent and good rate,promote the recovery of shoulder joint function,reduce the immune stress response,and reduce postoperative complications.

关 键 词：关节镜 TightRope钢板 肩锁关节 脱位 免疫反应 应激反应 

分 类 号：R687.4[医药卫生—骨科学]