关节镜缝线桥改良手术治疗老年全层肩袖损伤的临床分析  

Clinical analysis of arthroscopic modified suture-bridge surgery for full-thickness rotator cuff injury in elderly patients

作　　者：葛瑞 彭鹏 臧剑 徐鹏 许冠伟 GE Rui;PENG Peng;ZANG Jian;XU Peng;XU Guan-wei(Second Department of Bone Injury,Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine,Zhuhai Guangdong 519000,China)

机构地区：[1]珠海市中西医结合医院骨伤二科,广东珠海519000

出　　处：《局解手术学杂志》2025年第4期342-347,共6页Journal of Regional Anatomy and Operative Surgery

基　　金：广东省医学科学技术研究基金项目(A202107149)。

摘　　要：目的探讨关节镜缝线桥改良手术对老年全层肩袖损伤术后肩关节稳定性、疼痛、影像解剖参数的影响。方法选取2021年9月至2023年6月珠海市中西医结合医院收治的104例老年全层肩袖损伤患者,按照随机数字表法分为缝线桥组和改良组,每组52例。缝线桥组患者行关节镜缝线桥手术,改良组患者行关节镜缝线桥改良手术。比较2组患者围术期指标、手术前后肩关节活动度、美国肩肘外科协会(ASES)评分、视觉模拟量表(VAS)评分、Constant肩关节功能评分、美国加利福尼亚大学洛杉矶分校(UCLA)肩评分、肩关节恢复情况、影像Sugaya分级及并发症发生率。结果2组患者切口长度、手术时间、关节灌注量、术中失血量、住院时间比较,差异均无统计学意义(P>0.05);改良组患者术后6个月外旋活动度、前屈活动度、外展活动度均大于缝线桥组(P<0.05);改良组患者术后6个月ASES、Constant、UCLA评分高于缝线桥组,VAS评分低于缝线桥组,差异均有统计学意义(P<0.05);改良组术后6个月肩关节完全无痛、肩关节活动度与健侧相同、劳动能力恢复至术前患者占比高于缝线桥组,影像Sugaya分级优于缝线桥组,差异均有统计学意义(P<0.05);2组患者肩关节肿胀、患肢麻木、出血及再撕裂发生率比较,差异无统计学意义(P>0.05)。结论关节镜缝线桥改良手术治疗老年全层肩袖损伤患者能减轻术后疼痛程度,改善肩关节功能,扩大肩关节活动范围,改善影像解剖参数,且不会增加并发症发生率。Objective To investigate the effects of arthroscopic modified suture-bridge surgery on shoulder stability,pain and imaging anatomical parameters of elderly patients with full-thickness rotator cuff injury.Methods A total of 104 elderly patients with full-thickness rotator cuff injury admitted to Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine from September 2021 to June 2023 were selected and divided into the suture-bridge group and the modified group according to random number table method,with 52 cases in each group.Patients in the suture-bridge group underwent arthroscopic suture-bridge surgery,and patients in the modified group underwent arthroscopic modified suture-bridge surgery.Perioperative indexes,the range of motion of shoulder joint,American Shoulder and Elbow Surgeons(ASES)score,visual analogue scale(VAS)score,Constant shoulder function score,University of California Los Angeles(UCLA)shoulder score,recovery of shoulder joint,Sugaya classification of imaging before and after surgery,and the rate of complications were compared between the two groups.Results There was no significant difference in the length of incision,operation time,joint perfusion volume,intraoperative blood loss,or hospitalization time of patients between the two groups(P>0.05).The external rotation,forward flexion,and abduction ranges of motion 6 months after surgery of patients in the modified group were greater than those in the suture-bridge group(P<0.05);The ASES,Constant,and UCLA scores 6 months after surgery of patients in the modified group were higher than those in the suture-bridge group,while the VAS score was lower than that in the suture-bridge group,with statistically significant differences(P<0.05);The proportions of patients who experienced complete painlessness in shoulder joint,had the same range of motion as the healthy side,and recovered to work ability before surgery 6 months after surgery in the modified group were higher than those in the suture-bridge group,and the Sugaya classification o

关 键 词：肩袖损伤 关节镜 缝线桥改良手术 肩关节稳定性 并发症 

分 类 号：R687.4[医药卫生—骨科学] R684[医药卫生—外科学]