肩袖撕裂术后恢复期超声检查的价值初探

Value of Ultrasonography after Rotator Cuff Tear Surgery

目的评价超声检查在肩袖撕裂术后恢复期的应用价值。方法对30例肩袖撕裂术后患者行超声检查,结合患者的临床症状,对比分析超声声像图特征。结果 30例患者中有9例于术后1.5～2.0个月抬手臂受限,自觉疼痛症状较术前无明显改善,超声检查提示患侧冈上肌腱较对侧不同程度的增厚,回声强弱不均匀,三角肌下滑膜增厚,三角肌下滑囊可见积液;13例于术后3个月疼痛症状不同程度地减轻,手臂抬起不受限,部分夜间痛(+),超声检查显示患侧冈上肌腱较对侧增厚,三角肌下滑膜均不同程度地增厚;7例于术后6～7个月症状明显改善,疼痛消失,手臂举过头顶,无夜间痛,超声检查显示患侧冈上肌腱厚度与健侧相差无几,回声尚均匀,三角肌下滑膜无明显增厚,三角肌下滑囊未见积液;1例患者术后13个月无明显不适,超声检查显示患侧冈上肌腱回声均匀,厚度与健侧一样,三角肌下滑膜无增厚,三角肌下滑囊未见积液。患者在肩袖撕裂术后不同时期的临床症状与超声检查结果相符合。结论肩袖撕裂术后行超声检查具有很高的应用价值,可以作为首选的检查方法 。

Objective To evaluate the value of ultrasonography after rotator cuff tear surgery.Methods Thirty patients given rotator cuff tear surgery underwent ultrasonography.In combination with patients′ clinical symptoms,the characteristics of ultrasonography were analyzed comparatively.Results Of 30 patients,9 were constrained in lifting their arms 1.5～2.0 months after surgery,subjective pain symptom did not improve obviously as compared with pre-operation.Ultrasonography showed that tendon of supraspinatus muscle thickened more on affected side than on opposite,echo intensity was unhomogeneous,and deltoid inferior synovial membrane thickened with visible effusion in subdeltoid bursitis.The pain symptoms improved to varying degree in 13 patients 3 months after operation,not constrained in lifting their arms,some had hypnalgia（＋）.Ultrasonography showed that endon of supraspinatus muscle was thick on affected side than on opposite,and deltoid inferior synovial membrane thickened to varying degree.Seven patients had obvious improvement 6～7 months after operation,pain disappeared,arms could be raised above their heads,without hypnalgia.Ultrasonography showed that the thickness of tendon of supraspinatus muscle on affected side was little different from that on healthy side,echo even,no obvious thickness was noted in deltoid inferior synovial memebrane,nor was effusion in subdeltoid bursitis.Conclusion Ultrasonography,which is of very high application value in determination of postoperative rotator cuff tear,can be used as preferred method.