关节镜下清理结合小切口修补治疗肩袖损伤的临床效果及对疼痛和关节功能的影响

Clinical Effect of Arthroscopic Debridement Combined with Small Incision Repair on Rotator Cuff Injury and Its Effect on Pain and Joint Function

目的探究关节镜下清理结合小切口修补治疗肩袖损伤的临床效果及对疼痛和关节功能的影响。方法回顾性分析2018年7月-2022年7月治疗肩袖损伤105例的临床资料。根据手术方式不同将其分为对照组51例和研究组54例。对照组采用全开放式肩袖修补术,研究组采用关节镜下清理结合小切口修补术。观察2组临床疗效、手术时间、术中出血量、切口长度、术后引流量及住院时间,比较术前及术后1个月疼痛视觉模拟评分法(VAS)和美国肩肘外科协会(ASES)评分,并观察并发症发生情况。结果研究组治疗总有效率高于对照组(P<0.05)。2组手术时间比较差异无统计学意义(P>0.05);研究组术中出血量、切口长度、术后引流量以及住院时间均少于或短于对照组(P<0.05)。术后,2组VAS评分与术前比较降低,ASES评分与术前比较升高,且研究组VAS评分低于对照组,ASES评分高于对照组(P<0.05)。研究组并发症总发生率低于对照组(P<0.05)。结论关节镜下清理结合小切口修补治疗肩袖损伤的皮肤切口较小,住院时间较短,术后并发症较少,还能减少术中出血量及术后引流量,减轻疼痛程度,有效提升患者关节功能和活动性。

Objective To explore the clinical effect of arthroscopic debridement combined with small incision repair in the treatment of rotator cuff injury and its influence on pain and joint function.Methods The clinical data of 105 patients with rotator cuff injury treated from July 2018 to July 2022 were retrospectively analyzed.They were divided into control group(n=51)and research group(n=54)according to different operation methods.The control group was treated with full open rotator cuff repair,while the research group was treated with arthroscopic debridement combined with small incision repair.The clinical efficacy,duration of operation,intraoperative blood loss,incision length,postoperative drainage volume and length of hospital stay of the two groups were observed.The visual analogue scale(VAS)pain score and American Shoulder and Elbow Surgery Society(ASES)scores were compared before operation and at one month after operation,and the incidence of complications was observed.Results The total effective rate of the research group was higher than that of the control group(P<0.05).There was no significant difference in duration of operation between the two groups(P>0.05).The intraoperative blood loss,incision length,postoperative drainage volume and length of hospital stay in the research group were all less than or shorter than those in the control group(P<0.05).After operation,the VAS score of the two groups was lower than that before operation,while the ASES score was higher than that before operation;the VAS score of the research group was lower than that of the control group,while the ASES score was higher than that of the control group(P<0.05).The total incidence of complications in the research group was lower than that in the control group(P<0.05).Conclusion Arthroscopic debridement combined with small incision repair in the treatment of rotator cuff injury has smaller skin incision,shorter hospital stay,fewer postoperative complications,and can reduce intraoperative blood loss and postoperative drainage,reduce the degree of pain,and effectively improve the joint function and mobility of patients.