新型辅助套管在关节镜下大肩袖撕裂修复术中的应用  

Application of a novel auxiliary sleeve in arthroscopic repair of large rotator cuff tear

作　　者：冯超 刘启涛 秦浩然 丁连红 张登君[1] Feng Chao;Liu Qitao;Qin Haoran;Ding Lianhong;Zhang Dengjun(Department of Orthopaedics,The People’s Hospital of Shanxi Province,Taiyuan 030000,China)

机构地区：[1]山西省人民医院骨科,太原030000

出　　处：《中华创伤骨科杂志》2025年第2期133-142,共10页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨新型辅助套管协助关节镜下缝线桥技术治疗大肩袖撕裂的疗效。方法回顾性分析2022年7月至2024年1月在山西省人民医院骨科采用新型辅助套管协助关节镜下缝线桥技术治疗的35例大肩袖撕裂患者资料,设为观察组[男14例,女21例,年龄(58.3±10.3)岁]。根据1∶1配比选取2021年1月至2022年6月采用单纯关节镜下缝线桥技术治疗的35例大肩袖撕裂患者资料,设为对照组[男15例,女20例;年龄(55.3±10.5)岁]。比较两组患者手术时间、切口总长度、术前与术后第1天血红蛋白水平差值评价围手术期疗效差异。比较两组患者术后3个月美国肩肘外科协会(ASES)评分、美国加州大学洛杉矶分校(UCLA)评分、疼痛视觉模拟评分(VAS)来评价肩关节功能恢复和疼痛缓解情况差异,并各自与术前进行比较。结果两组患者术前一般资料比较差异均无统计学意义(P>0.05),具有可比性。70例患者术后获5.7(5.0,7.0)个月随访。两组患者术后均无肩袖再次撕裂、切口愈合不良、感染、锚钉退出等并发症发生。观察组手术时间133.3(120.0,140.0)min显著短于对照组171.7(140.0,200.0)min,差异有统计学意义(P<0.05)。对照组患者ASES、UCLA评分分别从术前的29.1(27.5,31.4)分和11.8(10.0,13.0)分提高至术后3个月随访时的56.0(51.9,59.5)分和24.6(22.0,27.0)分,疼痛VAS评分从术前的8.1(7.0,10.0)分降低至术后3个月随访时的2.0(2.0,2.0)分,差异均有统计学意义(P<0.05)。观察组ASES、UCLA评分分别从术前的29.9(29.1,31.2)分和12.6(11.0,14.0)分提高至术后3个月随访时的58.8(53.1,62.2)分和26.7(25.0,29.0)分,疼痛VAS评分从术前的8.0(7.0,9.0)分降低至术后3个月随访时的1.9(2.0,2.0)分,差异均有统计学意义(P<0.05)。术后3个月观察组UCLA评分显著优于对照组,差异有统计学意义(P<0.05)。两组患者在切口总长度、血红蛋白水平差值、术后3个月ASES评分及疼痛VAS评分方面的差异均�ObjectiveTo explore the clinical efficacy of suture-bridge techniques assisted by our self-designed novel auxiliary sleeve in arthroscopic repair of large rotator cuff tear.MethodsA retrospective analysis was conducted of the clinical data of 35 patients with large rotator cuff tear who had been treated by the arthroscopic suture-bridge technique assisted by our novel auxiliary sleeve at Department of Orthopaedics,The People’s Hospital of Shanxi Province from July 2022 to January 2024.The 35 patients were set as an observation group[14 males and 21 females with an age of(58.3±10.3)years].According to a 1:1 ratio,another 35 patients with large rotator cuff tear who had been treated by simple arthroscopic suture-bridge technique from January 2021 to June 2022 were selected as a control group[15 males and 20 females with an age of(55.3±10.5)years].The perioperative efficacy between the 2 groups was evaluated by comparing operation time,total length of incision,and disparity in hemoglobin level between preoperation and postoperative day 1.The American Shoulder and Elbow Surgeons(ASES)score,University of California,Los Angeles(UCLA)score,and visual analogue scale(VAS)pain score at 3 months after operation were compared between the 2 groups to evaluate the functional recovery and shoulder pain relief,and comparisons of the 3 scores were also made between preoperation and 3 months after operation in each group.ResultsThere were no statistically significant differences in the general preoperative data between the 2 groups,indicating comparability(P>0.05).The 70 patients were followed up for 5.7(5.0,7.0)months after operation.No such complications as recurrent rotator cuff tear,poor wound healing,infection,or anchor withdrawal occurred in either group after operation.The operation time in the observation group was 133.3(120.0,140.0)min,significantly shorter than 171.7(140.0,200.0)min in the control group(P<0.05).In the control group,the ASES and UCLA scores increased significantly from 29.1(27.5,31.4)points and 11.8(1

关 键 词：关节镜 肌腱病 肩关节 新型辅助套管 肩袖撕裂 

分 类 号：R687.3[医药卫生—骨科学]