关节镜下全缝线锚钉治疗肩袖损伤的短期临床疗效  

Short-term clinical effect of arthroscopic all-suture anchor nail in the treatment of rotator cuff injury

作　　者：鲍涛 胡洋洋 巩绪勇 王硕果 王亮 杨健 费文勇 卢耀甲[2] 杨宇夏[3] 刘殿伟 党孟博 李明俊 Bao Tao;Hu Yangyang;Gong Xuyong;Wang Shuoguo;Wang Liang;Yang Jian;Fei Wenyong;Lu Yaojia;Yang Yuxia;Liu Dianwei;Dang Mengbo;Li Mingjun(School of Clinical Medicine,Yangzhou University,Yangzhou 225001,China;Department of Sports Medicine,Northern Jiangsu People's Hospital,Yangzhou 225001,China;Dalian Medical University,Dalian 116044,China)

机构地区：[1]扬州大学临床医学院,扬州225001 [2]江苏省苏北人民医院运动医学科,日间手术中心,扬州225001 [3]大连医科大学,大连116044

出　　处：《中国运动医学杂志》2024年第1期3-10,共8页Chinese Journal of Sports Medicine

基　　金：江苏省卫健委科研课题(M2021042);扬州市重点研发计划(社会发展)项目(YZ2021084);国家骨科与运动康复临床医学研究中心项目(2021-NCRC-CXJJ-PY-07)。

摘　　要：目的:采用前瞻性、单队列临床试验评估关节镜下应用全缝线锚钉修复肩袖损伤的短期临床疗效。方法:以江苏省苏北人民医院运动医学科、日间手术中心自2022年7月至2022年9月收治的25例肩袖损伤(1.5 cm<撕裂大小<6 cm)患者作为研究对象,其中2例不符合入选标准被排除、1例因随访不便中途退出。共22例患者纳入研究,男8例、女14例;年龄59.1±10.9岁;左肩10例、右肩12例;肩袖撕裂大小为3.2±1.2 cm。记录患者术前、术后3个月、术后6个月随访时疼痛视觉模拟评分(VAS)、美国肩肘外科医师协会评分(ASES评分)、Constant-Murley肩关节功能评分(Constant评分)、简明肩关节评分(SST评分)、双肩外展肌力比值(患侧/健侧)及患肩关节活动度。通过术后6个月的磁共振成像(MRI)评估术后肩袖的愈合情况及全缝线锚钉周围囊肿形成情况,根据全缝线锚钉周围是否形成囊肿,将患者分为锚周囊肿组和锚周无囊肿组,比较分析两组患者的年龄、性别、左右侧、外伤史、病程时间、撕裂大小、手术时间,了解是否具有相关性;比较两组术后6个月的VAS评分、ASES评分、Constant评分、患肩关节活动范围和肩袖的愈合等级。结果:22例患者术后获6.2±0.3个月随访。术前、术后3月、术后6月,VAS评分分别为4.2±1.1、1.3±1.2、0.7±0.4分,ASES评分分别为51.5±11.2、79.7±12.3、88.9±6.5分,Constant评分分别为46.2±12.8、65.4±12.4、73.7±9.6分,双肩外展肌力比值(患侧/健侧)分别为21.9±15.8、71.3±9.6、90.3±5.9,SST评分分别为3.5±0.3、7.6±0.2、10.5±0.2分,与术前比较,术后3月、术后6月差异均有统计学意义(P<0.05)。术后3月、术后6月的肩关节活动范围与术前比较差异也均有统计学意义(P<0.05)。术后MRI提示肩袖再撕裂的患者1例。锚周围囊肿组和锚周无囊肿组两组患者年龄比较差异有统计学意义(P<0.05)。两组术后6月的VAS评分、ASES评分、ConstObjective To evaluate the short-term clinical effect of arthroscopic repair of rotator cuff injury with all-suture anchor using a prospective and single-cohort clinical trial.Methods Twenty-five patients with rotator cuff injuries(1.5 cm<lear size<6 cm)and admited to the Department of Sports Medicine and Ambulatory Surgery Centre of Jiangsu Provincial Subei People'8 Hospital between July and September 2022 were used as the study subjects.Two cases were exceluded for pot meeting the in-clusion criteria,while another one was withdrawn halfway due to inconvenience of follow-up.Finally..22 patients were included in the study,consisting of 8 males and 14 females.with the average age of 59.1±10.9 years and rotator cuff tear size of 3.2±1.2 cm of 10 left and 12 right shoulders.Be-fore as well as 3 and 6 months after operation,all patients were evaluated using the pain visual ana-logue scale(VAS),the American Shoulder and Elbow Surgeons(ASES)score,Constant-Murley Shoul-der Functional(Constant)Score,Simple Shoulder Test(SST),bilateral shoulder abduction muscle strength ratio(afcted/healthy),and mobility of the afcted shoulder joint.Six months after operation,the healing of rotator cuff and the formation of cyst around the all-suture anchor were evaluated by us-ing the magnetic resonance imaging(MRI).According to whether there was cysts around the all-suture anchor,the patients were divided into the cyst group and the cyst-free group.Their age,sex,the side afected,trauma history,course time,tear size and operation time of the two groups were com-pared and analyzed to find the correlated factors.The average VAS,ASES and Constant scores,and the range of motion of the afected shoulder joint and the healing grade of rotator cuff were compared between the two groups 6 months after operation.Results Twenty-two patients were granted 6.2±0.3 months of follow-up after surgery.Three and six months after the operation,their average VAS scores(1.3±±1.2 and 0.7±0.4),ASES scores(79.7±12.3 and 88.9±6.5),Constant scores(65.4±12.4

关 键 词：全缝线锚钉 肩关节 肩袖修补 肩袖损伤 锚周囊肿 

分 类 号：R687.3[医药卫生—骨科学]