探讨肱二头肌长头肌腱炎的手术策略

Surgical Strategy on Tendinitis of Iong Head of Biceps Brachii

目的探讨手术松解配合药物注射治疗顽固性肱二头肌长头肌腱炎的疗效。方法 2010年7月—2011年12月,该院对22例顽固性肱二头肌长头肌腱炎患者行松解术,术中配合使用复方倍他米松及透明质酸钠,术后2周和3个月随访肩部活动范围,并采用美国肩肘协会评分(ASES)评估。结果手术时间60～80min,平均75min,术中及术后未出现并发症。20例术后2周肩关节外展、前屈、后伸及外旋与术前比较明显改善,术后3个月改善更明显(P<0.01),22例术后2周及3个月ASES评分(88.7±5.2,89.2±6.6)与术前(39.5±10.1)比较,差异有统计学意义(n=22 t=20.7,21.1;P<0.01)。结论肱二头肌长头肌腱松解术配合复方倍他米松及透明质酸钠注射是治疗顽固性肱二头肌长头肌腱炎最直接和有效的方法。

Objective To investigate the effect of surgical lysis combined with the injection of drug on refractory tendinitis of long head of biceps brachii.Methods We have done surgical lysis to 22 patients with tendinitis of long head of biceps brachii from Jul.2010 to Dec.2011,with the Compound Betamethasone Injection and sodium hyaluronate in surgery.Follow up the range of motion of shoulder and the ASES of patients in two weeks and three months after surgery.Results Operation time ranged from 60～80min,with an average of 75min.No complications occurred in and after surgery.There was a significant improvement in abduction,flexion,extension and external rotation of shoulder in 20 patients in two weeks after surgery compared to preoperative,the improvement was more significant in three months after surgery（P0.01）.ASES scores in 22 patients improved distinctly in two weeks and three months after surgery（88.7±5.2,89.2±6.6） compared to preoperative（39.5±10.1）,signifiant improvement（n=22,t=20.7,21.6 P0.01）.Conclusion That myotenolysis of long head of biceps brachii combined with Compound Betamethasone Injection and injection of sodium hyaluronate is the most direct and effective way for tendinitis of long head of biceps brachii.