肩关节镜下单排与双排缝合固定手术治疗单纯冈上肌肌腱全层撕裂的效果比较  

Comparison of single-row and double-row suture fixation under shoulder arthroscopy in the treatment of simple full-thickness tear of supraspinatus tendon

作　　者：马利阁[1] 李松生 崔瑞开 郑永智 MA Li-ge;LI Song-sheng;CUI Rui-kai;ZHENG Yong-zhi(Department of Orthopedics,Fifth Clinical School of Henan University of Traditional Chinese Medicine(Zhengzhou People's Hospital),Zhengzhou 450004,Henan,CHINA;Department of Joint Diseases,Henan Provincial Hospital of Traditional Chinese Medicine(Second Affiliated Hospital of Henan University of Traditional Chinese Medicine),Zhengzhou 450011,Henan,CHINA)

机构地区：[1]河南中医药大学第五临床医学院(郑州人民医院)骨三科,河南郑州450004 [2]河南省中医院(河南中医药大学第二附属医院)关节病科,河南郑州450011

出　　处：《海南医学》2025年第4期482-487,共6页Hainan Medical Journal

基　　金：河南省教育厅厅局级课题(编号:23A360023)。

摘　　要：目的对比肩关节镜下双排与单排缝合固定手术治疗单纯冈上肌肌腱全层撕裂的效果。方法回顾性分析2021年5月至2023年12月郑州人民医院收治的150例单纯冈上肌肌腱全层撕裂患者的临床资料,依据不同手术方法分为对照组72例和研究组78例。对照组采用肩关节镜下单排缝合固定术治疗,研究组采用肩关节镜下双排缝合固定术治疗。比较两组患者的手术时间和住院时间、术前和术后6个月的视觉模拟评分(VAS)、美国肩肘外科协会评分(ASES)、加州大学肩关节评分系统(UCLA)和肩关节外旋与前屈活动度,同时比较两组患者的并发症发生率。结果研究组患者的手术时间为(113.09±15.73)min,明显长于对照组的(96.81±10.72)min,差异有统计学意义(P<0.05),但两组患者的住院时间比较差异无统计学意义(P>0.05);术后6个月,两组患者的VAS评分与术前比较均降低,且研究组患者的VAS评分为(2.15±0.40)分,明显低于对照组的(3.20±0.45)分,两组患者的ASES评分、UCLA评分与术前比较均增加,且研究组患者的ASES评分、UCLA评分分别为(87.18±5.03)分、(32.76±1.85)分,明显高于对照组的(80.51±7.42)分、(29.03±2.70)分,差异均有统计学意义(P<0.05);术后6个月,两组患者的肩关节外旋及前屈活动度与术前比较均增加,且研究组患者的肩关节外旋及前屈活动度分别为(50.86±3.49)°、(155.44±10.49)°,明显大于对照组的(44.01±3.73)°、(143.07±10.73)°,差异均有统计学意义(P<0.05);研究组患者的并发症发生率为1.28%,略低于对照组的6.94%,差异无统计学意义(P>0.05)。结论肩关节镜下双排缝合固定治疗单纯冈上肌肌腱全层撕裂的短期效果更佳,更能有效减轻患者疼痛,促进肩关节功能改善。Objective To compare the effect of double-row and single-row suture fixation under shoulder-to-shoulder arthroscopy in the treatment of simple full-thickness tear of supraspinatus tendon.Methods A retro-spective analysis was conducted on the clinical data of 150 patients with simple full-thickness tear of the supraspinatus tendon admitted to Zhengzhou People's Hospital from May 2021 to December 2023.According to different surgical methods,they were divided into a control group of 72 cases and a study group of 78 cases.Patients in the control group were treated with single-row suture fixation under shoulder arthroscopy,while those in the study group were treated with double-row suture fixation under shoulder arthroscopy.The surgical time and hospital stay,preoperative and postoperative Visual Analogue Scale(VAS),American Society of Shoulder and Elbow Surgeons(ASES),University of California Shoulder Scoring System(UCLA),and shoulder range of motion for external rotation and forward flexion,and the incidence of complications were compared between the two groups of patients.Results The surgical time of the study group was(113.09±15.73)min,which was significantly longer than(96.81±10.72)min of the control group(P<0.05).However,there was no statistically significant difference in the hospital stay between the two groups of patients(P>0.05).At 6 months after operation,the VAS scores in both groups were lower than those before operation,and the VAS score of the study group was(2.15±0.40)points,which was significantly lower than(3.20±0.45)points of the control group;the ASES score and UCLA score in both groups increased compared with those before operation,and the ASES score and UCLA score of the study group were(87.18±5.03)points and(87.18±5.03)points,which was significantly higher than(80.51±7.42)points and(29.03±2.70)points of the control group;the differences were statistically signifi-cant(P<0.05).At 6 months after operation,the shoulder joint range of motion for external rotation and forward flexion in both

关 键 词：肩袖撕裂 肩关节镜 双排缝合 单排缝合 疗效 

分 类 号：R687.4[医药卫生—骨科学]