关节镜下直接松解后肩袖关节修复术治疗肩袖损伤患者的随访研究

Follow-Up Study on the Treatment of Rotator Cuff Injury by Rotator Cuff Joint Repair After Direct Release Under Arthroscopy

目的分析关节镜下直接松解后肩袖关节修复术治疗肩袖损伤患者的效果。方法选取郑州市骨科医院2019年3月至2020年8月收治的82例肩袖损伤患者,按照随机数表法分为对照组和观察组,各41例。对照组接受手法松解后肩袖关节镜修复术治疗,观察组接受关节镜下直接松解后肩袖关节修复术治疗。比较两组手术情况(手术时间、术中失血量)、恢复情况(疼痛缓解时间、住院时间)、术前、术后1、3、6个月肩关节功能[美国肩肘外科协会(ASES)评分]、疼痛程度[视觉模拟评分量表(VAS)评分]以及术前及术后6个月肌肉力量(内旋、外旋、前屈)。结果观察组手术时间、疼痛缓解时间、住院时间均较对照组短,术中失血量较对照组少(P<0.05)。术后1、3、6个月,两组ASES评分均较术前升高,但观察组术后3、6个月ASES评分均低于对照组(P<0.05)。术后1、3、6个月,两组VAS评分均低于术前,但观察组术后3、6个月VAS评分均高于对照组(P<0.05)。术后6个月,两组肌肉力量均增加(P<0.05),而两组内旋、外旋、前屈评分比较,差异无统计学意义(P>0.05)。结论关节镜下直接松解后肩袖关节修复术治疗肩袖损伤,具有创伤小、术后恢复快等优势,可改善患者肩关节功能,但远期效果不理想。

Objective To analyze the effect of rotator cuff joint repair after direct release under arthroscopy in the treatment of rotator cuff injury.Methods A total of 82 patients with rotator cuff injury in Zhengzhou Orthopedic Hospital from March 2019 to August 2020 were selected and divided into control group and observation group according to the random number table method,with 41 cases in each group.Control group received arthroscopic rotator cuff repair after manual release,and observation group received rotator cuff joint repair after direct release under arthroscopy.The operation conditions(operation time and intraoperative blood loss),recovery(pain relief time and hospital stay),shoulder joint function[American Shoulder and Elbow Surgeons(ASES)score],pain degree[visual analog scale(VAS)score]before and 1,3 and 6 months after operation and muscle strength(internal rotation,external rotation and forward flexion)before and 6 months after operation were compared between the two groups.Results The operation time,pain relief time and hospitalization time of observation group were shorter than those of control group,and the blood loss during the operation was less than that of control group(P<0.05).One,three and six months after operation,the ASES scores of the two groups were all higher than those before operation,but three and six months after operation the ASES scores of observation group were both lower than those of control group(P<0.05).One,three and six months after operation,the VAS scores of the two groups were all lower than those before operation,but three and six months after operation the VAS scores of observation group were both higher than those of control group(P<0.05).Six months after operation,the muscle strength of the two groups increased(P<0.05),but there were no statistical differences in the scores of internal rotation,external rotation and forward flexion between the two groups(P>0.05).Conclusion Rotator cuff joint repair after direct release under arthroscopy in the treatment of rotator cuff injury has the advantages of less trauma and quick recovery after operation,which can improve the shoulder joint function of patients,but the long-term effect is not ideal.