通过MRI对关节镜下不同修补法治疗EllmanⅢ型PASTA损伤的临床效果评价  

Clinical evaluation of different methods of arthroscopic repair of Ellman′s typeⅢPASTA injury by MRI

作　　者：牛朋影[1,2] 蒋磊[1,2] 刘彩环 朱蓉蓉 王瑞[1,2] NIU Pengying;JIANG Lei;LIU Caihuan;ZHU Rongrong;WANG Rui(Medical Imaging Center,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;The Third Clinical Medical College of Ningxia Medical University,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院医学影像中心,宁夏银川750002 [2]宁夏医科大学第三临床医学院,宁夏银川750002

出　　处：《宁夏医学杂志》2024年第3期218-221,共4页Ningxia Medical Journal

摘　　要：目的通过磁共振成像(MRI)对关节镜下穿肌腱修补术及转全层修补术治疗EllmanⅢ型冈上肌肌腱关节侧部分撕裂(PASTA)损伤的临床效果进行评价。方法回顾性分析经关节镜诊断及治疗的肩关节EllmanⅢ型PASTA损伤患者42例,按手术修补方式将其分为穿肌腱修补组(22例)和转全层修补组(20例),患者术前、术后3个月及术后6~12个月随访均行肩关节MRI检查。比较2组患者术前、术后冈上肌横截面积、冈上肌脂肪浸润程度、冈上肌萎缩程度。结果2组患者术前、术后3个月及术后6~12个月冈上肌横截面积比较,差异无统计学意义(P>0.05)。2组患者术前、术后6~12个月冈上肌脂肪浸润程度比较,穿肌腱修补组术前与术后比较差异无统计学意义(P>0.05),转全层修补组术前与术后差异有统计学意义(P<0.05)。结论穿肌腱修补术和转全层修补术治疗EllmanⅢ型PASTA损伤,术后对冈上肌横截面积影响均不明显,术后对冈上肌萎缩程度均有影响,而转全层修补术后对冈上肌脂肪浸润程度有影响,穿肌腱修补术对其影响不明显。Objective To evaluate the clinical efficacy of arthroscopic tendon repair and full thickness repair for EllmanⅢPASTA injuries by Magnetic Resonance Imaging(MRI).Methods A retrospective analysis of 42 patients with PASTA injury of the shoulder joint diagnosed and treated by arthroscopy was performed.All patients were EllmanⅢtype and the patients were divided into a enetrating tendon repair group(n=22)and a full thickness repair group(n=20)according to surgical repair methods.Patients underwent shoulder joint MRI examination before surgery,3 months after surgery,and 6~12 months after surgery.Compare the cross-sectional area of the supraspinatus muscle,degree of fat infiltration in the supraspinatus muscle,and degree of atrophy in the supraspinatus muscle between the two groups before and after surgery.Results There was no statistically significant difference in the cross-sectional area of the supraspinatus muscle between the two groups of patients before surgery,3 months after surgery,and 6~12 months after surgery(P>0.05).Comparing the degree of fat infiltration of the supraspinatus muscle between the two groups of patients before and 6~12 months after surgery,there was no statistically significant difference(P>0.05)between the pre-and post-operation groups in the perforator tendon repair group,while there was a statistically significant difference(P<0.05)between the pre-operation and post-operation groups in the transition to full layer repair group.Conclusion In the treatment of Ellman typeⅢPASTA injury with transtenoplasty and full layer repair has no significant impact on the cross-sectional area of the supraspinatus muscle after surgery,but has an impact on the degree of atrophy of the supraspinatus muscle.Whereas the postoperative effect on the degree of supraspinatus muscle fat infiltration is influenced by transferring to full-layer repair,and the effect of through-tendon repair is not significant.

关 键 词：PASTA损伤 肩关节镜 修补术 磁共振成像 

分 类 号：R687.4[医药卫生—骨科学]