肩关节镜下手术治疗肩袖撕裂合并冻结肩的临床效果  

Clinical Effect of Shoulder Arthroscopic Surgery in the Treatment of Rotator Cuff Tear Combined with Frozen Shoulder

作　　者：刘牧子 龚时国[1] 谢荣辉[1] 沈鑫[1] 张紫红 LIU Muzi;GONG Shiguo;XIE Ronghui;SHEN Xin;ZHANG Zihong(Jiujiang NO.1 People's Hospital,Jiangxi Province,Jiujiang 332000,China;不详)

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2023年第36期34-38,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(SKJP20226181)。

摘　　要：目的:分析肩袖撕裂合并冻结肩患者在接受肩关节镜下手术疗法对术后疼痛程度的影响及对肩关节活动度、肩关节活动功能及术后并发症的影响。方法:选取九江市第一人民医院于2020年10月—2022年10月接诊的72例肩袖撕裂合并冻结肩疾病患者作为本次研究对象,根据抽签法将患者分为对照组和观察组,每组36例。对照组接受手法松解+关节镜下肩袖修补治疗,观察组接受关节镜下直接松解+关节镜下肩袖修补治疗。对比两组肩关节活动度评分、视觉模拟评分法(visual analogue scale,VAS)评分和美国肩肘外科医师评分标准(American shoulderand elbowsurgeons scale,ASES)评分及并发症发生率。结果:术前,两组前屈、外展、内旋、外旋等肩关节活动度评分进行对比,差异均无统计学意义(P>0.05);术后1个月,观察组上述肩关节活动度评分均高于对照组,差异均有统计学意义(P<0.05)。术前,两组VAS评分及ASES评分进行对比,差异均无统计学意义(P>0.05);术后7 d,观察组VAS评分低于对照组,ASES评分高于对照组,差异均有统计学意义(P<0.05)。观察组肩关节不稳、肌力减弱、关节囊出血等并发症总发生率为5.56%,明显低于对照组的22.22%,差异有统计学意义(P<0.05)。结论:相比于手法松解联合关节镜下肩袖修补治疗,关节镜下直接松解联合关节镜下肩袖修补用于治疗肩袖撕裂合并冻结肩患者效果更好,可明显提升患者肩关节活动度,有效减轻术后疼痛感,提升肩关节活动功能,降低并发症发生率。Objective:To analyze the effects of shoulder arthroscopic surgery treatment on postoperative pain,shoulder joint range of motion,shoulder joint mobility function and postoperative complications in patients with rotator cuff tear combined with frozen shoulder.Method:A total of 72 patients with rotator cuff tear combined with frozen shoulder disease were selected in Jiujiang NO.1 People's Hospital from October 2020 to October 2022,patients were divided into control group and observation group according to the method of drawing lots,with 36cases in each group,control group received manual release+arthroscopic rotator cuff repair treatment,observation group received arthroscopic direct release+arthroscopic rotator cuff repair treatment.The shoulder joint range of motion score,visual analogue scale(VAS)score and American shoulderand elbowsurgeons scale(ASES)score as well as the incidence of complications were compared between the two groups.Result:Before surgery,there were no significant differences between the two groups in terms of shoulder joint range of motion,such as anterior flexion,abduction,internal rotation and external rotation(P>0.05);one month after surgery,the above shoulder joint range of motion scores in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Before surgery,VAS scores and ASES scores of the two groups were compared,the difference were not statistically significant(P>0.05);7 days after surgery,VAS score of the observation group was lower than that of the control group,ASES score was higher than that of the control group,the differences were statistically significant(P<0.05).The total incidence of complications such as shoulder instability,muscle weakness and joint capsule bleeding in the observation group was 5.56%,which was significantly lower than 22.22%in the control group,the difference was statistically significant(P<0.05).Conclusion:Compared with manual release combined with arthroscopic rotator cuff repair,arthroscop

关 键 词：肩袖撕裂 冻结肩 肩关节镜下手术 

分 类 号：R687.4[医药卫生—骨科学]