关节镜下治疗慢性冈上肌钙化性肌腱炎的早期随访研究

Early follow-up study of arthroscopic treatment of chronic calcifying supraspinatus tendonitis

目的：探讨关节镜下治疗慢性冈上肌钙化性肌腱炎的早期疗效。方法：2013年3月至2015年9月为16例冈上肌钙化性肌腱炎患者行关节镜下冈上肌肌腱钙化灶清除术,术前及术后第3、6、12、18个月随访,采用美国肩肘外科协会评分系统（American shoulder and elbow surgeons scores,ASES）、Constant-Murley评分（Constant-Murley scores,CMS）及视觉模拟评分法（visual analogue scale,VAS）评价手术疗效,记录患者恢复功能锻炼的时间。结果：16例患者术后随访18~24个月,平均（20.4±1.7）个月。ASES评分由术前的（48.32±9.45）分提高至术后末次随访的（89.15±4.84）分,差异有统计学意义（t=-15.35,P〈0.01）;CMS评分由术前的（54.69±7.25）分提高至末次随访的（95.34±5.06）分,差异有统计学意义（t=-11.78,P〈0.05）;VAS疼痛评分由术前的（8.26±1.37）分减少至末次随访的（2.13±1.05）分,差异有统计学意义（t=-14.89,P〈0.01）。16例患者平均于术后（16.9±2.4）d恢复正常肩关节活动,术后肩部症状改善明显,关节活动度较前明显增加。结论：关节镜治疗保守无效的慢性冈上肌钙化性肌腱炎具有手术创伤小、患者康复快、病灶清除彻底的优点,早期随访结果满意,是可靠、有效的治疗方法。

Objective： To investigate the early efficacy of arthroscopic surgery for chronic calcifying supraspinatus tendinitis.Methods： From Mar. 2013 to Sep. 2015,16 patients with calcifying tendinitis of the supraspinatus were treated with shoulder arthroscopy. All patients underwent arthroscopic calcium excision and subacromial decompression,and were followed up in the preoperation and the postoperative 3,6,12,18 months. The preoperative and postoperative clinical efficacy were evaluated by the American shoulder and elbow surgeons score（ ASES）,Constant-Murley scores（ CMS） and visual analogue scale（ VAS） pain scores. Besides,the time of recovering functional exercise was recorded. Results： Sixteen patients were followed up for 18 to 24 months,with the average of（ 20. 4 ±1. 7） months. ASES scores were improved from（ 48. 32 ± 9. 45） points preoperatively to（ 89. 15 ± 4. 84） points postoperatively in the last follow-up,the difference was statistically significant（ t =-15. 35,P 0. 01）. CMS scores were increased from（ 54. 69 ± 7. 25）points preoperatively to（ 95. 34 ± 5. 06） points postoperatively in the last follow-up,the difference was statistically significant（ t =-11. 78,P 0. 05）. VAS pain scores were decreased from（ 8. 26 ± 1. 37） points preoperatively to（ 2. 13 ± 1. 05） points postoperatively in the last follow-up,the difference was statistically significant（ t =-14. 89,P 0. 01）. In the average of postoperative（ 16. 9 ± 2. 4） d,16 patients recovered to the normal. After treatment,the shoulder symptoms improved significantly,and the range of motion increased significantly than before. Conclusions： The arthroscopic treatment for the chronic calcific supraspinatus tendinitis is reliable,effective,mini-invasive therapy with quick recovery and radical removal of lesions,and the early follow-up results are satisfactory.