采用关节镜手术治疗肩袖撕裂损伤的临床疗效分析

Analysis of clinical therapeutic effect of arthroscopic operation for treatment of patients with rotator cuff tears

目的观察存关节镜下行手术治疗肩袖撕裂损伤的临床疗效。方法选取2013年1月至2015年9月长沙市第一医院骨科收治的120例肩袖撕裂损伤患者，以采用传统保守方法治疗的60例患者为对照组，以采用全关节镜或肩关节镜辅助切口手术治疗的60例患者为观察组。采用疼痛视觉模拟评分（VAS）法评估两组患者治疗前后肩袖损伤的疼痛情况；采用肩关节功能系统评分和美国肩肘外科医师评分（ASES）评价患者肩关节功能及恢复情况。结果患者术后均未出现肩袖二次断裂、感染、切口未愈合等并发症。两组治疗后VAS评分均较治疗前明显降低，ASES和肩关节功能系统评分均较治疗前明显升高，且观察组治疗后的变化较对照组更明显[VAS（分）：0．82±0．11比2．20±0．59，ASES（分）：82．21±10．81比70．53±6．21，疼痛评分（分）：9．81±0．21比9．11±0．51，功能评分（分）：9．70±0．09比8．80±0．40，前屈评分（分）：4．59±0．41比4．20±0．61，均P〈0．05]。结论关节镜下辅助切口手术治疗肩袖撕裂损伤患者疗效较为满意，值得临床深入研究。

Objective To observe the clinical effect of arthroscopic surgery on patients with rotator cuff tear injury. Methods One hundred and twenty patients with rotator cuff tears admitted to the Department of Orthopaedic of the First Hospital of Changsha from January 2013 to September 2015 were enrolled. Sixty patients treated with traditional conservative methods were assigned in a control group, the whole arthroscope or shoulder arthroscope was used to assist performing microsurgical incisions for another such 60 patients in the observation group. Visual analogue scale （VAS） of pain was applied to evaluate the pain of the patients with rotator cuff injury before and after treatment in both groups. The fimction of the shoulder joints and recovery situation were evaluated by using the shoulder functional system score and the American shoulder and elbow surgeon score （ASES）. Results The results showed that all patients had no postoperative complications such as secondary fracture of the rotator cuff tear, infection, incision non-healing, etc. Compared with those before treatment, in both groups, the VAS scores were obviously lowered after treatment, while ASES and shoulder function system scores after treatment were significantly higher than those before treatment, and the changes in the observation group were more pronounced than those in the control group （VAS： 0.82 ± 0.11 vs. 2.20 ± 0.59, ASES： 82.21 ± 10.81 vs. 70.53 ± 6.21, pain score： 9.81 ± 0.21 vs. 9.11 ±0.51, function score： 9.70 ± 0.09 vs. 8.80 ± 0.40, anterior flexion score： 4.59 ± 0.41 vs. 4.20± 0.61, all P 〈 0.05）. Conclusion The clinical effect of arthroseopic surgical treatment of patients with rotator cuff tear injury is relatively satisfactory and worthy to be deeply studied clinically.