小切口结合关节镜治疗肩袖损伤疗效观察

Observation of curative effect of small incision combined with arthroscopy on the treatment of rotator cuff injury

目的探讨小切口结合关节镜与全关节镜下治疗肩袖损伤的临床疗效比较。方法回顾性研究河北省沧州市南大港医院肩袖损伤120例,分为全关节镜组57例(61肩),小切口结合关节镜组63例(67肩),至少随访15个月,平均随访24个月,根据患者住院时间、手术并发症、关节活动度、肌力、彩超及核磁共振(MRI)评价术后肩袖愈合情况等,并采用加州大学肩关节评分系统(UCLA)、视觉疼痛量表(VAS)、美国肩与肘协会评分系统(ASES)评分进行比较。结果 2组患者手术后ASES、UCLA、VAS评分测试结果均较术前有明显改善,差异具有统计学意义(P<0.01),但2组组间术后评分改善情况的比较差异无统计学意义(P>0.05)。结论小切口结合关节镜治疗肩袖损伤与全关节镜下治疗肩袖损伤临床效果均满意,2种治疗方法对肩关节活动范围、肩关节功能评分、满意度及术后并发症等指标的疗效相当。

Objective To discuss the effect of small incision combined with arthroscopy and All- arthroscopic treatment on rotator cuff injury. Methods 120 cases with rotator cuff injury were retrospectively studied and divided into two groups. There were 57 cases in All- arthroscopic treatment group. There were 63 cases in small incision combined with arthroscopy group. At least 15 months of follow- up,mean follow- up of 24 months,according to the patient hospitalization,surgical complications,range of motion,muscle strength,ultrasound and magnetic resonance（ MRI） were evaluated rotator cuff healing,etc.,and the use of the University of California,shoulder Scoring System（ UCLA）,pain scale（ VAS）,American Shoulder and elbow Society scoring system（ ASES） score were compared. Results After surgery ASES,UCLA,VAS score in 2 groups of patients have improved significantly compared with before surgery（ P〈0. 01）,but there was no difference between two groups on postoperative score improvement（ P〈0. 05）. Conclusion The effect of small incision combined with arthroscopy and All- arthroscopic treatment on rotator cuff injury was satisfied,two treatment methods for shoulder joint activities,shoulder joint function score,satisfaction,and the curative effect of postoperative complications such as index was therapeutic equivalence.