康复训练在全关节镜下修复肩袖损伤术后的疗效分析

Observation of the effectiveness of rehabilitation after arthroscopic rotator cuff repair

目的观察康复训练对全关节镜下修复肩袖损伤术后肩关节功能的疗效。方法选取肩袖损伤后行全关节镜肩袖修补术的患者共74例，将其分为治疗组39例和对照组35例，2组均在术后进行肩关节被动训练，治疗组在肩关节被动训练的基础上增加3阶段康复训练。2组患者均于术前、术后6个月、术后1年、术后2年、术后3年采用美国肩肘医师协会评分（ASES）、加州大学肩关节评分系统UCLASS评分（UCLASS）、视觉模拟评分（VAS）进行肩关节功能评定。结果术前，2组患者ASES、UCLASS、VAS评分的组间差异均无统计学意义（P〉0．05），术后6月、1年、2年、3年时，治疗组的ASES、UCLASS、VAS评分明显优于对照组同时段（P〈0．05），术后6月、1年、2年、3年，治疗组的VAS评分分别为（1．3±0．3）分、（1．00±0．3）分、（0．8±0．3）分、（0．8±0．2）分，均显著优于治疗前的（6．6±0．9）分（P〈0．01）。术后，2组患者各时段肩关节的疼痛、功能、主动前屈活动度、前屈力量和主观满意度较术前均显著改善（P〈0．05），且显著优于同时段的对照组，差异均有统计学意义（P〈0．05）。结论对关节镜修复肩袖损伤术后患者提供早期系统个性化的肩关节康复训练可促进肩关节功能有效恢复，治疗效果更好。

Objective To discuss the effectiveness of rehabilitation training after arthroscopic rotator cuff repair. Methods Seventy-four cases of arthroscopic rotator cuff repair were studied. They were randomly divided into a treatment group and a control group. Both groups received shoulder passive motion training after the operation. The treatment group also received 3-phase shoulder exercises for rehabilitation, changes in American shoulder ＆ el- bow surgeons＇ scores （ASES scores）, University of California at Los Angeles shoulder scoring system scores （UCLASS） , and visual analogue scale （VAS） scores were assessed pre-operation, and 6 months and 1, 2 and 3 years later. Results There was no difference between the groups pre-operation. After the operation, significant im- provements in all the outcome measurements were observed in the treatment group. Significant improvement in VAS scores was observed only in the treatment group. Shoulder pain, mobility, range of active forward flexion, strength of forward flexion and patient satisfaction all improved significantly more in the treatment group than in the control group. Conclusions Early and systematic rehabilitation training is an effective way to improve the function of the shoulder joint after arthroscopic rotator cuff repair.