快速康复外科理念在关节镜下治疗冻结肩中的应用

Application of the Notion of Fast-Track Surgery in Treating Frozen Shoulder under Arthroscopy

目的:探讨快速康复外科理念在肩关节镜下治疗冻结肩中的应用效果。方法:回顾性分析收治的冻结肩患者57例,术前所有患者诊断为冻结肩并在关节镜下行松懈术。将57例患者随机分为传统康复组(TRG)和快速康复组(FTS),其中FTS组32例,男11例,女21例,平均年龄57.6岁(45~67岁);TRG组25例,男10例,女15例,平均年龄55.1岁(43~63岁)。术后1周、1个月、3个月随访时比较两组美国肩与肘协会评分系统(ASES)评分、ConstantMurley评分、加州大学肩关节评分系统(UCLA)、住院时间及患者满意度。结果:术后1周、1个月ASES评分、ConstantMurley评分、UCLA评分、住院时间、患者满意度、住院总费用FTS均明显低于TRG(P<0.05);切口愈合不良发生率两组差异无统计学意义(P>0.05)。FTS术后3个月时Constant-Murley评分、UCLA评分、ASES评分、患者满意度与TRG比较差异无统计学意义(P>0.05)。结论:快速康复外科理念在关节镜下治疗冻结肩,术后应用快速康复外科理念可有效促进患者早期康复,改善肩关节评分,具有提高患者满意度、缩短住院时间等优点。

Objective To explore the application effect of the notion of fast-track surgery in treating frozen shoulder under arthroscopy. Method 57 patients with frozen shoulder were analyzed retrospectively. All patients were diagnosed with frozen shoulder alone before operation and underwent frozen shoulder Release operation under arthroscopy. These patients were randomly divided into fast-track surgery group（ FTS） and traditional rehabilitation group（ TRG）. 32 cases in FTS group,11 were male and 21 were female with an average age of 57. 6 years old（ 45 ~ 67 years）; 25 cases in TRG group,10 were male and 15 were female with an average age of 55. 1years old（ 43 ~ 63 years）. Two groups were compared in terms of the rating scale of American Shoulder and Elbow Surgeons（ ASES）,Constant score,the University of California at Los Angeles Shoulder Rating Scale（ UCLA）,patients＇ satisfaction and length of stay after operation at 1 week,1 month and 3 months follow-ups,respectively. Results The AESE scores,Constant scores,UCLA scores and patient＇s satisfaction at 1 week and 1 month and 3 month after operation,length of stay after operation,and total hospitalization expense of FTS and TRG were not difference（ P〉0. 05）; there was no statistically significant difference in the occurrence rate of undesirable incision healing between the two groups（ P〉0. 05）. The UCLA score,Constant score and patient＇s satisfaction three months after operation of FTS were much higher than those of TRG（ P〈0. 05）. Conclusion The application of the notion of fast-track surgery in treating frozen shoulder under arthroscopy can effective promote patients＇ early rehabilitation after operation,improve their shoulder joint scores,reduce their hospital stays and enhance their satisfaction. Thus,it should be promoted in clinical practice.