生物多糖胶液联合肩关节镜松解治疗肩袖撕裂伴冻结肩患者的疗效观察  

Efficacy of biopolysaccharide gel solution combined with shoulder arthroscopic release in the treatment of rotator cuff tear with frozen shoulder patients

作　　者：包金平 王守朝 郑念宗 BAO Jin-ping;WANG Shou-chao;ZHENG Nian-zong(Department of Orthopaedics,Jinchang People's Hospital,Jinchang Gansu 737100,China)

机构地区：[1]金昌市人民医院骨科,甘肃金昌737100

出　　处：《临床和实验医学杂志》2024年第20期2160-2164,共5页Journal of Clinical and Experimental Medicine

基　　金：甘肃省科技计划项目(编号:21J000218)。

摘　　要：目的观察生物多糖胶液联合肩关节镜松解治疗肩袖撕裂伴冻结肩患者的临床疗效。方法前瞻性选取2021年1月至2024年1月金昌市人民医院收治的肩袖撕裂伴冻结肩患者90例作为研究对象,按照随机数字表法将其分为观察组和对照组,每组各45例。观察组给予肩关节镜松解联合肩袖修复术治疗,并用生物多糖胶液冲洗关节腔;对照组仅给予肩关节镜松解联合肩袖修复术治疗,未注入药物。比较两组术前、术后12周、24周的肩关节活动度(ROM),血清相关因子[β-内咖肽(β-EP)、前列腺素2(PG2)、肿瘤坏死因子-α(TNF-α)、红细胞沉降率(ESR)],疼痛[视觉模拟评分法(VAS)评分],肩关节功能[Constant-Murley评分、美国肩肘协会评分系统(ASES)评分]变化,统计两组关节再粘连、术后感染等发生率。结果术后12、24周,两组的肩关节内旋、外旋、外展、前屈ROM均较术前升高,且观察组的肩关节内旋、外旋、外展、前屈ROM均高于对照组,差异均有统计学意义(P<0.05)。术后12、24周,两组β-EP水平均较术前升高,PG2、TNF-α、ESR水平均较术前降低,且观察组术后12、24周的β-EP水平均高于对照组,PG2、TNF-α、ESR水平均低于对照组,差异均有统计学意义(P<0.05)。术后12、24周,两组VAS评分均较术前降低,Constant-Murley评分、ASES评分均较术前升高,且观察组术后12、24周的VAS评分均低于对照组,Constant-Murley评分、ASES评分均高于对照组,差异均有统计学意义(P<0.05)。观察组关节再粘连发生率为0,低于对照组(8.89%),差异有统计学意义(P<0.05)。对照组发生术后感染2例,观察组发生术后感染1例。两组并发症发生率比较(2.22%vs.4.44%),差异无统计学意义(P>0.05)。结论生物多糖胶液联合肩关节镜松解治疗肩袖撕裂伴冻结肩可改善ROM,减轻术后疼痛,有效提高肩关节功能,并降低术后关节再粘连的发生,值得临床推广应用。Objective To observe the efficacy of biopolysaccharide gel solution combined with shoulder arthroscopic release in the treatment of rotator cuff tear with frozen shoulder patients.Methods A total of 90 patients with rotator cuff tear and frozen shoulder admitted to Jinchang People's Hospital from January 2021 to January 2024 were prospectively selected as the study subjects.According to the random number table method,they were divided into the observation group and the control group,45 cases in each group.The observation group was treated with shoulder arthroscopic release combined with rotator cuff repair,and the joint cavity was irrigated with biopolysaccharide gel solution,while the control group was only treated with shoulder arthroscopic release combined with rotator cuff repair without injecting drugs.The range of motion(ROM)of shoulder joint,serum related factors[β-endocrine(β-EP),prostaglandin 2(PG2),tumor necrosis factor-α(TNF-α),erythrocyte sedimentation rate(ESR)],pain[visual analogue scale(VAS)score],shoulder joint function[Constant-Murley score,American Shoulder and Elbow Society(ASES)score]were compared between the two groups before operation,12 and 24 weeks after operation,and the incidence of joint re-adhesion and postoperative infection in the two groups were counted.Results At 12 and 24 weeks after operation,the ROM of internal rotation,external rotation,abduction and flexion of shoulder joint in the two groups were higher than those before operation,and the ROM of internal rotation,external rotation,abduction and flexion of shoulder joint in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).At 12 and 24 weeks after operation,the levels ofβ-EP in the two groups were higher than those before operation,and the levels of PG2,TNF-αand ESR were lower than those before operation,and the levels ofβ-EP in the observation group were higher than those in the control group at 12 and 24 weeks after operation,and the levels of PG2,

关 键 词：肩关节 生物多糖胶液 肩关节镜松解 肩袖撕裂 冻结肩 肩关节活动度 关节再粘连 

分 类 号：R687.4[医药卫生—骨科学]