超声引导下经皮灌洗治疗肩袖钙化性肌腱炎的远期效果及其影响因素分析

Long-Term Effect of Ultrasound-Guided Percutaneous Lavage on Rotator Cuff Calcification Tendonitis and Its Influencing Factors

目的探讨超声引导下经皮灌洗治疗肩袖钙化性肌腱炎(Rotator cuff calcific tendinopathy,RCCT)的远期效果及其影响因素。方法:前瞻性选取2018年1月至2020年6月我院接受超声引导治疗的245例RCCT患者为研究对象,随访观察1年,根据治疗效果分为有效组和无效组,通过多因素Logistic回归探求超声引导经皮灌洗治疗RCCT远期疗效的影响因素。结果:截止2021年7月1日,共13例失访,最终纳入232例,其中42例无效,190例有效,无效率为18.10%;两组基线视觉模拟评分法(Visual analogue scale,VAS)评分、钙化灶直径、钙化类型、肩峰-三角肌下囊壁厚度对比差异具有统计学意义(P<0.05);多因素Logistic分析显示,VAS评分(OR=2.254,95%CI1.060~4.796)、钙化灶直径(OR=1.878,95%CI1.370~2.575)、肩峰-三角肌下囊壁厚度(OR=7.521,95%CI2.030~27.870)、钙化类型(OR=1.151,95%CI1.015~1.305)为超声引导下RCCT远期治疗效果的危险因素(均P<0.05)。结论:超声引导下经皮灌洗治疗可使RCCT患者明显获益,VAS评分、钙化灶直径、钙化类型、肩峰-三角肌下囊壁厚度可预测超声引导下RCCT的远期治疗效果。

To explore the long-term effect and predictive factors of ultrasound-guided percutaneous lavage in the treatment of rotator cuff calcified tendinitis(RCCT).Method:Prospectively selected 245 RCCT patients who received ultrasound-guided treatment in our hospital from January 2018 to June 2020 as the research objects.Follow-up observation for 1 year was divided into effective group and ineffective group according to the treatment effect.Multi-factor Logistic regression was used to explore the factors affecting the long-term efficacy of ultrasound-guided percutaneous lavage in the treatment of RCCT.Result:As of July 1,2021,a total of 13 cases were lost to follow-up,and 232 cases were finally included.Among them,42 cases were invalid,and the invalid rate was 18.10%.190 cases were effective,and the invalid rate was 18.10%.There were statistically significant differences in the baseline Visual analogue scale(VAS)score,calcification foci diameter,calcification type,and acromiosubdeltoid capsule wall thickness between the two groups(P<0.05);Multivariate Logistic analysis showed that the VAS score(OR=2.254,95%CI1.060~4.796),the diameter of the calcification foci(OR=1.878,95%CI1.370~2.575),the subacromial/inferior deltoid cyst wall thickness(OR=7.521,95%CI2.030~27.870),calcification type(OR=1.151,95%CI1.015~1.305)were risk factors for the long-term treatment effect of RCCT under ultrasound guidance(all P<0.05).Conclusion:Ultrasound-guided percutaneous lavage treatment can significantly benefit RCCT patients.VAS score,calcification diameter,calcification type,and thickness of the subacromial-deltoid capsule wall can predict the long-term treatment effect of RCCT under ultrasound guidance.