肩关节镜下肩袖修复术治疗巨大肩袖撕裂的效果分析
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摘要
目的探究肩关节镜下肩袖修复术治疗巨大肩袖撕裂的临床效果。方法选取2013年1月～2017年8月我院收治的巨大肩袖撕裂患者60例,根据随机数字表法将其分为观察组和对照组各30例。观察组于肩关节镜下行肩袖修复术,对照组于肩关节镜下行清创减压术,记录患者手术一般资料及恢复运动时间,于术后3个月和6个月时比较两组肩关节活动度和美国肩肘外科医师学会(ASES)评分。结果观察组恢复运动时间短于对照组(P <0.05)。术后3个月和6个月时观察组肩关节前屈、后伸和外旋角度均大于对照组(P均<0.05)。术后3个月和6个月时观察组ASES评分均高于对照组(P均<0.05)。结论在改善肩关节功能方面,肩关节镜下行巨大肩袖撕裂行肩袖修补效果明显优于关节清理,值得临床推广应用。
Objective To explore the clinical curative effect of rotator cuff repair under shoulder arthroscopy in treatment of huge rotator cuff tear.Methods 60 patients with huge rotator cuff tear who were admitted and treated in our hospital from January 2013 to August 2017 were selected.According to the random number table method,they were divided into the observation group and the control group,with 30 cases in each group.The observation group underwent rotator cuff repair under shoulder arthroscopy while the control group underwent debridement and decompression under shoulder arthroscopy.General data of operation and recovery time of exercises were recorded.The shoulder mobility and the American Society of Shoulder and Elbow Surgeons(ASES)scores were compared on 3 and 6 months after operation.Results The recovery time of exercise in the observation group was shorter than that of the control group(P < 0.05).On 3 months and 6 months after operation,the anteflexion angle,posterior extensionangle and external rotation angle of the observation group were all larger than those in the control group(all P < 0.05).On 3 months and 6 months after operation,ASES scores of the observation group were higher than those in the control group(all P < 0.05).Conclusion In the improvement of shoulder function,rotator cuff repair under shoulder arthroscopy in treatment of huge rotator cuff tear has better curative effects than joint debridement.It is worthy of clinical promotion and treatment.
Objective To explore the clinical curative effect of rotator cuff repair under shoulder arthroscopy in treatment of huge rotator cuff tear.Methods 60 patients with huge rotator cuff tear who were admitted and treated in our hospital from January 2013 to August 2017 were selected.According to the random number table method,they were divided into the observation group and the control group,with 30 cases in each group.The observation group underwent rotator cuff repair under shoulder arthroscopy while the control group underwent debridement and decompression under shoulder arthroscopy.General data of operation and recovery time of exercises were recorded.The shoulder mobility and the American Society of Shoulder and Elbow Surgeons(ASES)scores were compared on 3 and 6 months after operation.Results The recovery time of exercise in the observation group was shorter than that of the control group(P < 0.05).On 3 months and 6 months after operation,the anteflexion angle,posterior extensionangle and external rotation angle of the observation group were all larger than those in the control group(all P < 0.05).On 3 months and 6 months after operation,ASES scores of the observation group were higher than those in the control group(all P < 0.05).Conclusion In the improvement of shoulder function,rotator cuff repair under shoulder arthroscopy in treatment of huge rotator cuff tear has better curative effects than joint debridement.It is worthy of clinical promotion and treatment.
引文
[1]傅仰攀,黄长明,尹宗生.全肩关节镜与关节镜辅助治疗肩袖损伤的比较[J].中国矫形外科杂志,2016,24(20):1839-1843.
[2]田谦.关节镜下缝线桥与双排锚钉修复肩袖撕裂的疗效观察[J].现代仪器与医疗,2017,23(2):113-115.
[3]康汇,李剑,李红川,等.关节镜下经肌腱原位修补治疗肩袖关节侧部分撕裂的疗效观察[J].中国骨与关节损伤杂志,2016,31(11):1204-1205.
[4]Bell S,Lim YJ,Coghlan J.Long-term longitudinal followup of mini-open rotator cuff repair[J].J Bone Joint Surg Am,2013,95(2):151-157.
[5]Encalada-Diaz I,Cole BJ,Macgillivray JD,et al.Rotator cuff repair augmentation using a novel polycarbonate polyurethane patch:preliminary results at 12 months follow-up[J].JShoulder Elbow Surg,2011,20(5):788-794.
[6]李磊,黄兆钢,王伟.肩关节镜下治疗巨大肩袖撕裂的临床疗效观察[J].河北医学,2016,22(11):1844-1846.
[7]王跃华,周凯,陈锋,等.关节镜下锚钉固定治疗肩关节Bankart损伤临床疗效观察[J].现代医药卫生,2017,33(15):2331-2333.
[8]李良军,丑克,何志勇,等.肩关节镜下治疗巨大肩袖撕裂的疗效观察[J].中国内镜杂志,2015,21(10):1077-1081.
[9]宁凡友,李无阴,张作君,等.关节镜下修复巨大肩袖撕裂12例疗效分析[J].中国骨与关节损伤杂志,2014,29(9):942-943.
[10]李嘉,徐丛,常乾坤,等.肩关节镜下辅助小切口治疗肩袖撕裂的中长期疗效观察[J].重庆医学,2017,46(16):2260-2262.
[11]黎键,穆中杰.关节镜下治疗肩袖撕裂伴肩关节粘连疗效观察[J].浙江中西医结合杂志,2017,27(6):514-516.
[12]党鹏,尼加提·阿不力米提,李纲,等.肩峰成形对关节镜下肩袖全层撕裂修复术后疗效的影响[J].新疆医学,2016,46(9):1073-1076.
[13]吴富章,华伟伟,蔡靖宇,等.全关节镜下清创减压术和直接修复术治疗巨大肩袖撕裂的效果比较[J].解放军医药杂志,2016,28(6):33-35.
[14]Nho SJ,Shindle MK,Sherman SL,et al.Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair[J].J Bone Joint Surg Am,2007,89(3):127-136.
[15]Liem D,Alci S,Dedy N,et al.Clinical and structural results of partial supraspinatus tears treated by subacromial decompression without repair[J].Knee Surg Sports Traumatol Arthrosc,2008,16(10):967-972.
[2]田谦.关节镜下缝线桥与双排锚钉修复肩袖撕裂的疗效观察[J].现代仪器与医疗,2017,23(2):113-115.
[3]康汇,李剑,李红川,等.关节镜下经肌腱原位修补治疗肩袖关节侧部分撕裂的疗效观察[J].中国骨与关节损伤杂志,2016,31(11):1204-1205.
[4]Bell S,Lim YJ,Coghlan J.Long-term longitudinal followup of mini-open rotator cuff repair[J].J Bone Joint Surg Am,2013,95(2):151-157.
[5]Encalada-Diaz I,Cole BJ,Macgillivray JD,et al.Rotator cuff repair augmentation using a novel polycarbonate polyurethane patch:preliminary results at 12 months follow-up[J].JShoulder Elbow Surg,2011,20(5):788-794.
[6]李磊,黄兆钢,王伟.肩关节镜下治疗巨大肩袖撕裂的临床疗效观察[J].河北医学,2016,22(11):1844-1846.
[7]王跃华,周凯,陈锋,等.关节镜下锚钉固定治疗肩关节Bankart损伤临床疗效观察[J].现代医药卫生,2017,33(15):2331-2333.
[8]李良军,丑克,何志勇,等.肩关节镜下治疗巨大肩袖撕裂的疗效观察[J].中国内镜杂志,2015,21(10):1077-1081.
[9]宁凡友,李无阴,张作君,等.关节镜下修复巨大肩袖撕裂12例疗效分析[J].中国骨与关节损伤杂志,2014,29(9):942-943.
[10]李嘉,徐丛,常乾坤,等.肩关节镜下辅助小切口治疗肩袖撕裂的中长期疗效观察[J].重庆医学,2017,46(16):2260-2262.
[11]黎键,穆中杰.关节镜下治疗肩袖撕裂伴肩关节粘连疗效观察[J].浙江中西医结合杂志,2017,27(6):514-516.
[12]党鹏,尼加提·阿不力米提,李纲,等.肩峰成形对关节镜下肩袖全层撕裂修复术后疗效的影响[J].新疆医学,2016,46(9):1073-1076.
[13]吴富章,华伟伟,蔡靖宇,等.全关节镜下清创减压术和直接修复术治疗巨大肩袖撕裂的效果比较[J].解放军医药杂志,2016,28(6):33-35.
[14]Nho SJ,Shindle MK,Sherman SL,et al.Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair[J].J Bone Joint Surg Am,2007,89(3):127-136.
[15]Liem D,Alci S,Dedy N,et al.Clinical and structural results of partial supraspinatus tears treated by subacromial decompression without repair[J].Knee Surg Sports Traumatol Arthrosc,2008,16(10):967-972.