全关节囊喙肱韧带松解术联合肩峰下清理减压术治疗肩周炎  

Clinical effects of the coracohumeral ligament release combined with subacromial decompression in the treatment of periarthritis humeroscapularis

作　　者：谢志云 金大地 赵亮[1] XIE Zhiyun;JIN Dadi;ZHAO Liang(Department of Joint and Bone Disease Surgery,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of Orthopaedics,Susong Hospital,Xiamen 361006,China;Department of Orthopaedics,the Third Affiliated Hospital of Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院关节与骨病外科,广州510515 [2]厦门市苏颂医院骨科,厦门361006 [3]南方医科大学第三附属医院骨科,广州510515

出　　处：《中华骨与关节外科杂志》2024年第12期1119-1124,共6页Chinese Journal of Bone and Joint Surgery

摘　　要：目的:探讨全关节囊喙肱韧带松解术联合肩峰下清理减压术对肩周炎的治疗效果。方法:选取2020年5月至2022年7月广州华新骨科医院收治的43例肩周炎患者作为研究对象,按就诊顺序进行随机分组,单号进入松解组(22例,采用全关节囊喙肱韧带松解术),双号进入联合组(21例,采用全关节囊喙肱韧带松解术联合肩峰下清理减压术)。比较两组患者手术时间、住院时间,记录患者术后并发症的发生情况。并以手术前后肩关节功能Constant-Murley评分、疼痛视觉模拟评分(VAS)、肩关节活动度(前屈、外展、外旋)评估患者肩关节症状和功能情况。结果:患者随访时间为12~17个月,平均(14.1±1.5)个月。所有患者术后均未出现关节脱位、腋神经损伤、感染等并发症。术后4周、8周、3个月、6个月,联合组患者Constant-Murley评分均高于松解组,差异均有统计学意义(P均<0.05)。术后4、8周,联合组患者疼痛VAS评分均低于松解组,差异均有统计学意义(P均<0.05)。术后4周、8周、3个月,联合组患者肩关节前屈活动度均大于松解组,差异均有统计学意义(P均<0.05)。结论:全关节囊喙肱韧带松解术联合肩峰下清理减压术治疗肩周炎在缓解疼痛、改善肩关节功能及日常活动能力方面优于单纯的全关节囊喙肱韧带松解术,尤其在术后早期恢复上效果更为显著。Objective:To investigate the effects of the coracohumeral ligament release combined with subacromial decompression on scapulohumeral periarthritis.Methods:A total of 43 patients with scapulohumeral periarthritis were admitted to Guangzhou Huaxin Orthopaedic Hospital from May 2020 to July 2022.The patients were randomly divided into two groups according to the order of visit:odd-numbered patients were assigned to the release group(22 cases treated with the coracohumeral ligament release)and even-numbered patients were assigned to the combined group(21 cases treated with the coracohumeral ligament release combined with subacromial decompression).The operation time and hospital stay of the two groups were compared,and the occurrence of postoperative complications was recorded.The shoulder joint function Constant-Murley score,visual analog score(VAS)for pain,and shoulder joint mobility(forward flexion,abduction,external rotation)were used to assess the symptoms and functions of the shoulder joint before and after surgery.Results:All patients were followed for 12 to 17 months,with an average of(14.1±1.5)months.No patients had complications such as joint dislocation,axillary nerve injury,or infection after surgery.At 4 weeks,8 weeks,3 months,and 6 months postoperatively,the Constant-Murley score in the combined group was significantly higher than that in the release group(all P<0.05).At 4 weeks and 8 weeks postoperatively,the VAS score for pain was significantly lower in the combined group than in the release group(all P<0.05).At 4 weeks,8 weeks,and 3 months postoperatively,the forward flexion mobility of the shoulder joint in the combined group was significantly greater than that in the release group(all P<0.05).Conclusions:The coracohumeral ligament release combined with subacromial decompression is more effective than arthroscopic release of the coracohumeral ligament in relieving pain and improving shoulder joint function and daily activity ability,especially in the early postoperative recovery period.

关 键 词：肩周炎 关节镜 喙肱韧带 肩峰 

分 类 号：R687.4[医药卫生—骨科学]