关节镜下缝线桥分层修复术治疗肩袖分层撕裂的临床研究

发布时间：2018-02-16 01:33

本文关键词： 肩袖分层撕裂缝线桥分层修复全层修复　出处：《中国修复重建外科杂志》2017年10期 　论文类型：期刊论文

【摘要】：目的评价关节镜下缝线桥分层修复术治疗肩袖分层撕裂的临床疗效。方法将2013年5月—2015年5月符合选择标准的54例肩袖分层撕裂患者纳入研究,随机分为两组,试验组28例行关节镜下缝线桥分层缝合修复,对照组26例行关节镜下缝线桥全层缝合修复。两组患者性别、年龄、侧别、撕裂类型以及术前疼痛视觉模拟评分(VAS)、肩关节Constant评分、美国肩肘外科协会评分(ASES)、美国加州大学洛杉矶分校(UCLA)评分、肩关节前屈活动度、体侧外旋活动度比较,差异均无统计学意义(P0.05)。术后随访并比较两组肩关节功能评分、活动度及肩袖再撕裂发生情况。结果试验组手术时间较对照组延长,比较差异有统计学意义(t=8.383,P=0.000)。术后两组切口均Ⅰ期愈合,无手术相关并发症发生。患者均获随访12个月,两组术后12个月时UCLA、ASES、VAS、Constant评分及肩关节前屈、外旋活动度与术前比较,差异均有统计学意义(P0.05);两组间以上指标比较,差异均无统计学意义(P0.05)。术后12个月,试验组4例(14.3%)、对照组5例(19.2%)患者发生肩袖再撕裂,发生率比较差异无统计学意义(χ~2=0.237,P=0.626)。结论关节镜下缝线桥分层修复术治疗肩袖分层撕裂,在肩关节功能评分、肩关节活动度及术后再撕裂方面与传统缝线桥全层固定术比较无明显差异,而且手术时间较长。
[Abstract]:Objective to evaluate the clinical effect of arthroscopic suture bridge laminar repair in the treatment of rotator cuff delamination tear. Methods from May 2013 to May 2015, 54 patients with rotator cuff delamination tear were included in the study and randomly divided into two groups. 28 patients in the test group were treated with arthroscopic suture bridge suture repair, and 26 patients in the control group were treated with arthroscopic suture bridge suture repair. Sex, age, side type, tear type and preoperative pain visual analogue score (VASA), shoulder joint Constant score were used in the two groups. The American Society of shoulder and Elbow surgery score (ASESA), UCLAs (UCLAs), shoulder flexion and lateral lateral rotation were not significantly different. All the patients were followed up after operation and compared with the two groups in terms of shoulder joint function. Results the operative time in the experimental group was longer than that in the control group, and the difference was statistically significant. The incisions of the two groups were healed in the first stage and no complications occurred. The patients were followed up for 12 months. At 12 months after operation, the UCLA ASESV constant score, shoulder anterior flexion and external rotation were significantly different from those before operation (P 0.05), but there was no significant difference between the two groups in the above indexes (P 0.05), 12 months after operation, there was no significant difference between the two groups (P 0.05), and there was no significant difference between the two groups at 12 months after operation, and there was no significant difference between the two groups at 12 months after operation. There was no significant difference in the incidence of rotator cuff retear in 4 patients in the trial group and in 5 patients in the control group (蠂 ~ 2 + 0.237). Conclusion the arthroscopic suture bridge repair is used to treat the rotator cuff delamination tear, and the function of shoulder joint is evaluated. There was no significant difference in range of motion of shoulder joint and postoperative tear compared with traditional suture bridge full layer fixation, and the operative time was longer.
【作者单位】：承德医学院附属医院关节外科;
【基金】：2017年度河北省医学科学研究重点课题计划(20170233)~~
【分类号】：R687.4

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