先单纯肩关节前脱位复位后评定疗效4种评分量表的比较研究

Comparison of four scoring scales in functional evaluation of anterior shoulder after reduction for simple join dislocation

目的：分析4种肩关节评分量表评估肩关节前脱位功能的稳定性和可靠性。方法纳入两家医院共100例符合标准的肩关节前脱位患者，男48例，女52例；平均42.3岁（21-54岁）。均臂丛麻醉下复位，采用Constant- Murley肩关节评分（CMS表）、Rowe肩关节功能评分（Rowe表）、美国加州大学洛杉矶分校肩关节功能评分标准（UCLA表）、美国肩肘外科医生评估表（ASES表）和SF-36量表评估患者3个月后的量表分值，第1次评估1周后再次对患者进行4个肩关节量表评估。结果 CMS、Rowe、U-CLA、ASES量表内部可信度Cronbach’s Alpha值为分别为0.871、0.765、0.766、0.822。4个量表组内相关系数为0.918、0.430、0.772、0.970，具有相关性（P＜0.05）。CMS、Rowe、UCLA、ASES与SF-36量表的相关系数分别为0.841、0.737、0.665、0.912，具有相关性（P＜0.05）。结论4个肩关节量表中ASES表对肩关节前脱位功能评估性能相对较好，但是对患者整体肩关节状况的评估仍缺乏特异性，需要制定出主观性和客观性更为均衡的量表来评估肩关节前脱位后功能的恢复情况。

Objective To compare four scoring scales in functional evaluation of anterior shoulder after reduction for simple joint dislocation. Methods One hundred patients with simple anterior shoulder join dislocation, including 48 males and 52 females with a mean age of 42.3y （21-54y）, underwent reduction procedure under brachial plexus block. The CMS （Constangt- Murley score）, Rowe score, UCLA （University of California at Los Angeles scale）, ASES （rating scale of the American shoulder and elbow surgeons） were used to evaluate shoulder function and SF- 36 was used to assess the quality of life on 3 months after reduction, and the second evaluation with the same scales were performed 1 week later. Results The Cronbach＆#39;s Alpha values of CMS, Rowe score, UCLA and ASES were 0.871, 0.765, 0.766 and 0.822, respectively. The intra- class correlation coefficient of CMS, Rowe score, UCLA and ASES were 0.918, 0.430, 0.772 and 0.970（P〈0.05）. The correlation coefficients of CMS, Rowe score, UCLA and ASES with SF- 36 were 0.841, 0.737, 0.665 and 0.912, respectively（P〈0.05）. Conclusion The performance of ASES for ante-rior shoulder function evaluation is relatively good, but lacks specificity for overal shoulder joint assessment. More balanced sub-jective and objective scales are needed for functional evaluation of anterior shoulder dislocation after joint reduction.