全关节镜下修补术与关节镜辅助下小切口修补术对于肩袖损伤的临床疗效的比较与分析

发布时间：2019-01-19 18:37

【摘要】：目的:探讨全关节镜下修补与关节镜辅助下小切口修补术对于肩袖损伤的临床疗效。方法:选择2012年1月～2015年1月在我院治疗的肩袖损伤患者86例的临床资料进行回顾性分析,依据治疗方式的不同分为两组,将采用关节镜辅助下小切口肩袖修补术治疗的46例患者作为关节镜辅助下小切口修补组;将采用全关节镜下肩袖修补术治疗的40例患者作为全关节镜下修补组。比较两组治疗前后肩关节活动度、肌力情况以及ASES评分、UCLA评分以及VAS评分。结果:关节镜辅助下小切口修补组术后外展活动度131.4±18.8°,外旋64.9±8.8°,内旋63.7±7.3°;全关节镜下修补组术后外展活动度132.3±16.9°,外旋65.1±9.4°,内旋64.4±8.1°;两组术后肩关节活动度较治疗前均显著增加,差异有统计学意义(P0.05);但两组治疗后肩关节活动度比较差异无统计学意义(P0.05)。关节镜辅助下小切口修补组术后肌力:外展4.6±0.2级,外旋4.7±0.3级,内旋4.9±0.3级;全关节镜下修补组术后肌力:外展4.7±0.3级,外旋4.8±0.2级,内旋4.8±0.2级;两组术后肌力较术前均显著增加,差异有统计学意义(P0.05);但两组术后肌力比较差异无统计学意义(P0.05)。治疗后,关节镜辅助下小切口修补组ASES评分88.4±8.9分,UCLA评分29.6±3.6分,VAS评分1.4±0.3分;全关节镜下修补组ASES评分89.5±9.6分,UCLA评分30.8±4.1分,VAS评分1.3±0.4分;治疗后两组ASES评分、UCLA评分较治疗前显著增加,VAS评分较治疗前显著下降,差异有统计学义(P0.05);但治疗后两组间比较差异无统计学意义(P0.05)。平均随访时间为20.8个月(18～35)个月。结论:全关节镜下修补与关节镜辅助下小切口修补术对于肩袖损伤均具有一定的临床疗效,可以提升手术治疗安全性以及可靠性,但是全关节镜下修补术损伤更小。
[Abstract]:Objective: to investigate the clinical effect of arthroscopic repair and arthroscopic small incision repair for rotator cuff injury. Methods: 86 patients with rotator cuff injury treated in our hospital from January 2012 to January 2015 were retrospectively analyzed and divided into two groups according to the different treatment methods. Forty-six patients with arthroscopic small incision rotator cuff repair were treated as arthroscopic small incision repair group. Forty patients treated with arthroscopic rotator cuff repair were selected as total arthroscopic repair group. Shoulder motion, muscle strength, ASES score, UCLA score and VAS score were compared before and after treatment. Results: in the arthroscopic small incision repair group, the postoperative abduction motion, external rotation and internal rotation were 131.4 卤18.8 掳, 64.9 卤8.8 掳and 63.7 卤7.3 掳, respectively. The range of abduction, rotation and internal rotation were 132.3 卤16.9 掳, 65.1 卤9.4 掳and 64.4 卤8.1 掳, respectively, in the total arthroscopic repair group, and the range of shoulder motion in the two groups was significantly higher than that before treatment (P0.05). However, there was no significant difference in the range of shoulder motion between the two groups after treatment (P0.05). In the arthroscopic small incision repair group, the muscle strength was 4.6 卤0.2 grade, 4.7 卤0.3 grade and 4.9 卤0.3 grade respectively. Total arthroscopic repair group postoperative muscle strength: abduction 4.7 卤0.3 grade, external rotation 4.8 卤0.2 grade, internal rotation 4.8 卤0.2 grade, the two groups were significantly higher than before, the difference was statistically significant (P0.05); However, there was no significant difference in postoperative muscle strength between the two groups (P0.05). After treatment, the ASES score, UCLA score, VAS score and VAS score were 88.4 卤8.9, 29.6 卤3.6 and 1.4 卤0.3 in the arthroscopic small incision repair group. The ASES score, UCLA score, VAS score and VAS score were 89.5 卤9.6, 30.8 卤4.1 and 1.3 卤0.4, respectively. After treatment, the ASES score, UCLA score and VAS score of the two groups were significantly increased compared with before treatment, the difference was statistically significant (P0.05), but there was no significant difference between the two groups after treatment (P0.05). The mean follow-up time was 20.8 months (18 / 35). Conclusion: total arthroscopic repair and arthroscopic small incision repair have certain clinical effects on rotator cuff injury, which can improve the safety and reliability of surgical treatment, but the total arthroscopic repair injury is less.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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