全肩关节镜和关节镜辅助小切口手术治疗肩袖损伤的对比研究

A comparative study on the treatment of rotator cuff injury with total shoulder arthroscopic and arthroscopic assisted small incision surgery

目的探讨应用全肩关节镜手术与关节镜辅助下小切口手术治疗肩袖损伤的疗效差异及对术后关节功能的影响。方法选取2020年1月~2022年12月收治的肩袖损伤并接受手术治疗的患者93例,随机分A组和B组,A组47例、B组46例。A组接受关节镜辅助下小切口手术,B组接受全肩关节镜手术。比较两组手术失血量、手术用时、住院用时、视觉模拟疼痛评分(VAS)、美国加州大学肩关节功能评分(UCLA)及整体疗效差异。结果术前两组VAS评分、UCLA评分比较,差异无统计学意义(P>0.05),术后1月、3月、6月B组各时间点VAS评分均低于A组(P<0.05),B组UCLA评分均高于A组(P<0.05);B组手术失血量、住院时间少于A组,手术用时高于A组(P<0.05);两组治疗总优良率比较,差异无统计学意义(P>0.05)。结论两种手术整体疗效相近;关节镜下小切口手术创伤性低,手术用时短;全肩关节镜手术失血量少、住院用时短,且术后疼痛与关节功能恢复效率更高。

Objective To explore the difference in therapeutic effects between total shoulder arthroscopic surgery and arthroscopic assisted small incision surgery for the treatment of rotator cuff injuries,and their impact on postoperative joint function.Methods 93 patients with rotator cuff injury admitted to a hospital from January 2020 to December 2022 who underwent surgical treatment were randomly divided into group A and group B,with 47 cases in group A and 46 cases in group B.Group A underwent arthroscopic assisted small incision surgery,while group B underwent total shoulder arthroscopic surgery.Compared the blood loss in surgery,surgical time,hospitalization time,visual analogue pain score(VAS),shoulder joint function score(UCLA),and overall efficacy between the two groups.Results Before surgery,there were no statistically significant difference in the VAS score and UCLA score between the two groups(P>0.05).1 month,3 months,6 months after surgery,the VAS score of group B was lower than that of group A at all time points(P<0.05),and the UCLA score of group B was higher than that of group A(P<0.05);the surgical blood loss and hospitalization time in group B were lower than those in group A,and the surgical time was higher than that in group A(P<0.05);there was no statistically significant difference in the total excellent and good rates between the two groups(P>0.05).Conclusion The overall efficacy of the two surgeries is similar;arthroscopic small incision surgery has low trauma and short surgical time;total shoulder arthroscopic surgery has lower blood loss,shorter hospitalization time,and higher postoperative pain and joint function recovery efficiency.