关节镜下线桥技术治疗中老年人肩袖全层撕裂的临床疗效观察
发布时间：2018-10-04 22:58
【摘要】：1目的通过本研究观察关节镜下线桥技术治疗中老年人肩袖全层撕裂的临床效果。2方法2012年12月至2014年4月采用关节镜下线桥技术治疗中老年人肩袖全层撕裂患者86例,男32例,女54例；手术时年龄51岁一78岁,平均62.4±5.6岁。左肩20例,右肩66例。累及优势肩75例。术前病程从3个月到35个月,平均病程13.6个月,根据手术前肩关节正位,冈上肌出口位X线片及MRI检查及查体体征确定手术方案,采用肩关节镜线桥技术治疗86例患肩。86例患者都获得6个月的随访。患肩均测定术前术后休息和活动时的VAS评分,肩关节前屈、外展和体侧外旋角度,美国加州大学肩关节评分(UCLA)和美国肩肘外科医生评分(ASES)对治疗前后进行评估,并对相关指标进行评估研究。3结果休息时VAS评分从术前(6.3±3.2)分降到末次随访时(0.8±1.4)分(t=5.34,P=0.03),活动时VAS评分从术前的(7.7±2.1)分降到末次随访时(1.7±1.6)分(t=-5.66,P=0.02)。关节前屈角度从术前(110°±52°)到术后末次随访时(146°±28°)(t=4.56,P=0.02),外展角度从术前(105°±53°)到术后末次随访时(140°±22°)(t=4.54,P=0.03),体侧外旋角度从术前(31°±14°)到术后末次随访时(35°±10°)(t==4.52,p=0.04).UCLA评分由术前的(15.1±4.6)分增加到末次随访时(30.2±2.5)(t=5.78,p=0.02);ASES评分由术前的(30.2±16)分增加到末次随访时(80.4±13)分(t=5.74,P=0.03)。休息时和活动时的VAS评分均较术前明显改善(t值分别为5.34和5.66)。术后平均前屈角度增加48.4。,平均外展角度增加45。,平均体侧外旋角度增加4.2。,改变均有统计学意义(前屈、外展和体侧外旋的t值分别为4.56,4.54和4.52,P=0.02,P=0.03,P=0.04)。4结论关节镜下线桥技术治疗中老年人肩袖全层撕裂有效。通过严格手术适应症的把握,术后合理康复,锚钉合理的选择,临床再撕裂是可以避免的。
[Abstract]:Objective to observe the clinical effect of arthroscopic line bridge technique in the treatment of rotator cuff full-layer tear in middle-aged and elderly patients. Methods 86 cases of middle-aged and elderly patients with rotator cuff full-thickness tear were treated with arthroscopic line bridge from December 2012 to April 2014. There were 32 males and 54 females, aged from 51 to 78 years (mean 62.4 卤5.6 years). Left shoulder 20 cases, right shoulder 66 cases. The superior shoulder was involved in 75 cases. The preoperative course of disease ranged from 3 months to 35 months, with an average course of 13.6 months. According to the anterior position of the shoulder joint, the exit position of the supraspinatus muscle, X-ray film, MRI examination and physical examination, the operative plan was determined. All 86 patients were followed up for 6 months. The VAS score, shoulder flexion, abduction and lateral rotation angle were measured before and after operation. The shoulder joint score (UCLA) at the University of California and the American shoulder and elbow surgeon score (ASES) were evaluated before and after treatment. Results the VAS score at rest decreased from (6.3 卤3.2) to (0.8 卤1.4) at the last follow-up (t = 5.34), and the VAS score at activity decreased from (7.7 卤2.1) to (1.7 卤1.6) at the last follow-up (t-5.66 P0. 02). The angle of joint flexion from preoperative (110 掳卤52 掳) to last follow-up (146 掳卤28 掳) (t 4.56 掳), abduction angle (105 掳卤53 掳) to postoperative last follow-up (140 掳卤22 掳) (t 4.54 掳P0.03), lateral rotation angle from preoperative (31 掳卤14 掳) to postoperative last follow-up (35 掳卤10 掳). UCLA score increased from preoperative (15.1 卤4.6) to final follow-up (35 掳卤10 掳). UCLA score increased from (15.1 卤4.6) to last follow-up. The ASES score increased from (30.2 卤16) before operation to (80.4 卤13) at the last follow-up (t = 5.74). VAS scores at rest and activity were significantly improved compared with those before operation (t = 5.34 and 5.66, respectively). The mean flexion angle, average abduction angle and lateral rotation angle were increased by 48.4.4,45.The mean lateral rotation angle increased by 4.2.The changes were statistically significant (anterior flexion; T values of abduction and lateral rotation were 4.56 卤4.54 and 4.52 respectively. Conclusion Arthroscopic technique is effective in the treatment of rotator cuff full-thickness tear in middle-aged and elderly patients. Clinical retear can be avoided by strict indication of operation, reasonable rehabilitation after operation, reasonable choice of anchor nail.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4
本文编号：2252209
[Abstract]:Objective to observe the clinical effect of arthroscopic line bridge technique in the treatment of rotator cuff full-layer tear in middle-aged and elderly patients. Methods 86 cases of middle-aged and elderly patients with rotator cuff full-thickness tear were treated with arthroscopic line bridge from December 2012 to April 2014. There were 32 males and 54 females, aged from 51 to 78 years (mean 62.4 卤5.6 years). Left shoulder 20 cases, right shoulder 66 cases. The superior shoulder was involved in 75 cases. The preoperative course of disease ranged from 3 months to 35 months, with an average course of 13.6 months. According to the anterior position of the shoulder joint, the exit position of the supraspinatus muscle, X-ray film, MRI examination and physical examination, the operative plan was determined. All 86 patients were followed up for 6 months. The VAS score, shoulder flexion, abduction and lateral rotation angle were measured before and after operation. The shoulder joint score (UCLA) at the University of California and the American shoulder and elbow surgeon score (ASES) were evaluated before and after treatment. Results the VAS score at rest decreased from (6.3 卤3.2) to (0.8 卤1.4) at the last follow-up (t = 5.34), and the VAS score at activity decreased from (7.7 卤2.1) to (1.7 卤1.6) at the last follow-up (t-5.66 P0. 02). The angle of joint flexion from preoperative (110 掳卤52 掳) to last follow-up (146 掳卤28 掳) (t 4.56 掳), abduction angle (105 掳卤53 掳) to postoperative last follow-up (140 掳卤22 掳) (t 4.54 掳P0.03), lateral rotation angle from preoperative (31 掳卤14 掳) to postoperative last follow-up (35 掳卤10 掳). UCLA score increased from preoperative (15.1 卤4.6) to final follow-up (35 掳卤10 掳). UCLA score increased from (15.1 卤4.6) to last follow-up. The ASES score increased from (30.2 卤16) before operation to (80.4 卤13) at the last follow-up (t = 5.74). VAS scores at rest and activity were significantly improved compared with those before operation (t = 5.34 and 5.66, respectively). The mean flexion angle, average abduction angle and lateral rotation angle were increased by 48.4.4,45.The mean lateral rotation angle increased by 4.2.The changes were statistically significant (anterior flexion; T values of abduction and lateral rotation were 4.56 卤4.54 and 4.52 respectively. Conclusion Arthroscopic technique is effective in the treatment of rotator cuff full-thickness tear in middle-aged and elderly patients. Clinical retear can be avoided by strict indication of operation, reasonable rehabilitation after operation, reasonable choice of anchor nail.
【学位授予单位】：中国中医科学院
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.4
【参考文献】
相关期刊论文 前2条
1 汪洋;;肩袖损伤的研究概况[J];井冈山医专学报;2008年01期
2 庄泽;卢华定;陈郁鲜;彭优;任建华;王昆;;肩袖损伤后单排与双排缝合方法比较的Meta分析[J];中国组织工程研究;2014年29期
，本文编号：2252209
本文链接：https://www.wllwen.com/yixuelunwen/waikelunwen/2252209.html
最近更新
教材专著
