全关节镜与关节镜辅助下小切口肩袖修补术对肩袖撕裂患者术后疼痛程度的影响

Effects of Total Arthroscopic and Arthroscopic Assisted Small Incision Rotator Cuff Repair on Postoperative Pain Level in Patients With Rotator Cuff Tear

目的观察全关节镜与关节镜辅助下小切口肩袖修补术对肩袖撕裂患者术后疼痛程度的影响。方法选取我院收治的64例肩袖撕裂患者作为研究对象,依据随机数表法分成实验组和对照组各32例。实验组患者给予全关节镜下肩袖修补术,对照组患者给予关节镜辅助下小切口肩袖修补术。观察两组患者术前及术后6个月时两组患者肩关节功能[简明肩关节功能测试(SST)、Constant肩关节评分系统]和肌力变化,比较两组患者围术期情况差异。结果术后6个月时,两组患者SST、Constant评分及外展、外旋、内旋肌力分级均较术前显著升高,且实验组明显高于同一时间对照组(P<0.05)。两组患者手术时间、出血量、植入锚钉个数、术后住院天数及术后24h VAS评分差异均无统计学意义(P>0.05)。结论全关节镜与关节镜辅助下小切口肩袖修补术应用于肩袖撕裂患者临床围术期情况相当,均能减轻疼痛,而前者更利于肩关节功能和肌力恢复,具有较高临床应用价值。

Objective To observe the effects of total arthroscopic and arthroscopic assisted smallincision rotator cuff repair on postoperative pain level in patients with rotator cuff tear.Methods Totally 64 patients with rotator cuff tear in our hospital were selected as the research subjects,and they were divided into experimental group and control group according to the random number table method,with 32 cases in each group.Patients in experimental group received all-arthroscopic rotator cuff repair,and patients in control group received arthroscopicassisted small incision rotator cuff repair.The changes of shoulder joint function [Simple Shoulder Test(SST),Constant Shoulder Joint Score System] and muscle strength were observed in the two groups before surgery and at 6 months after surgery,and the differences in perioperative status were compared between the two groups.Results At 6 months after surgery,the SST,Constant score and muscle strength grades of abduction,external rotation and internal rotation in the two groups were significantly higher than those before surgery,and the scores in experimental group were significantly higher than those in control group at the same time point(all P<0.05).There were no statistically significant differences in the surgical time,blood loss,number of implanted anchors,postoperative hospital stay and VAS score at 24 h after surgery between the two groups(all P>0.05).Conclusion Total arthroscopic and arthroscopic assisted small incision rotator cuff repair in patients with rotator cuff tear are similar in clinical perioperative status,and both can relieve pain,but the former one is more conducive to the recovery of shoulder joint function and muscle strength,and has higher clinical application value.