本文關(guān)鍵詞： 肩袖分層撕裂 縫線橋 分層修復(fù) 全層修復(fù)　出處：《中國修復(fù)重建外科雜志》2017年10期 　論文類型：期刊論文

【摘要】：目的評(píng)價(jià)關(guān)節(jié)鏡下縫線橋分層修復(fù)術(shù)治療肩袖分層撕裂的臨床療效。方法將2013年5月—2015年5月符合選擇標(biāo)準(zhǔn)的54例肩袖分層撕裂患者納入研究,隨機(jī)分為兩組,試驗(yàn)組28例行關(guān)節(jié)鏡下縫線橋分層縫合修復(fù),對(duì)照組26例行關(guān)節(jié)鏡下縫線橋全層縫合修復(fù)。兩組患者性別、年齡、側(cè)別、撕裂類型以及術(shù)前疼痛視覺模擬評(píng)分(VAS)、肩關(guān)節(jié)Constant評(píng)分、美國肩肘外科協(xié)會(huì)評(píng)分(ASES)、美國加州大學(xué)洛杉磯分校(UCLA)評(píng)分、肩關(guān)節(jié)前屈活動(dòng)度、體側(cè)外旋活動(dòng)度比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后隨訪并比較兩組肩關(guān)節(jié)功能評(píng)分、活動(dòng)度及肩袖再撕裂發(fā)生情況。結(jié)果試驗(yàn)組手術(shù)時(shí)間較對(duì)照組延長,比較差異有統(tǒng)計(jì)學(xué)意義(t=8.383,P=0.000)。術(shù)后兩組切口均Ⅰ期愈合,無手術(shù)相關(guān)并發(fā)癥發(fā)生�；颊呔@隨訪12個(gè)月,兩組術(shù)后12個(gè)月時(shí)UCLA、ASES、VAS、Constant評(píng)分及肩關(guān)節(jié)前屈、外旋活動(dòng)度與術(shù)前比較,差異均有統(tǒng)計(jì)學(xué)意義(P0.05);兩組間以上指標(biāo)比較,差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。術(shù)后12個(gè)月,試驗(yàn)組4例(14.3%)、對(duì)照組5例(19.2%)患者發(fā)生肩袖再撕裂,發(fā)生率比較差異無統(tǒng)計(jì)學(xué)意義(χ~2=0.237,P=0.626)。結(jié)論關(guān)節(jié)鏡下縫線橋分層修復(fù)術(shù)治療肩袖分層撕裂,在肩關(guān)節(jié)功能評(píng)分、肩關(guān)節(jié)活動(dòng)度及術(shù)后再撕裂方面與傳統(tǒng)縫線橋全層固定術(shù)比較無明顯差異,而且手術(shù)時(shí)間較長。
[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.
【作者單位】： 承德醫(yī)學(xué)院附屬醫(yī)院關(guān)節(jié)外科;
【基金】：2017年度河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃(20170233)~~
【分類號(hào)】：R687.4

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