关节镜下高位关节内与小切口低位关节外结节间沟下LHBT切断固定治疗伴有肱二头肌长头肌腱炎SIS的对照研究

A Comparative Study of Arthroscopic Treatment of Acromion Impingement Syndrome with Tendinitis of Biceps Brachii Long Head(LHBT)in High Joint and Low Intertrochanteric Groove with Small Incision

目的:探讨关节镜下高位关节内与小切口低位关节外结节间沟下肱二头肌长头腱(Long Head of the Biceps Tendon,LHBT)切断固定治疗伴有肱二头肌长头肌腱炎肩峰撞击综合征(subacromial impingement syndrome,SIS)的对照研究。方法:选取2019年月12月至2022年12月在我院诊治的伴有肱二头肌长头肌腱炎SIS患者92例,其中45例接受关节镜下高位关节内LHBT切断固定治疗(观察A组),47例接受小切口低位关节外结节间沟下LHBT切断固定治疗(观察B组),比较两组治疗前后的加州大学(UCLA)肩关节评分系统各维度评分及总分、Constant肩关节评分评分、美国肩肘关节医师协会(ASES)评分,以及临床治疗疗效。结果:治疗后,两组UCLA各维度评分、患者满意度及总分较治疗前均升高(P<0.05),但与观察B组比较,观察A组UCLA各维度评分、患者满意度及总分治疗前后的差值明显更低(P<0.05)。治疗后,两组Constant、ASES评分较治疗前均升高(P<0.05),但与观察B组比较,观察A组Constant、ASES评分治疗前后的差值明显更低(P<0.05)。与观察B组95.74%比较,观察A组临床治疗总有效率80.00%明显更低(P<0.05)。结论:与关节镜下高位关节内LHBT切断固定治疗相比较,小切口低位关节外结节间沟下LHBT切断固定治疗伴有肱二头肌长头肌腱炎SIS患者,可更有效促进肩关节功能恢复,提高临床治疗疗效。

Objective:To investigate the comparative study of arthroscopic high intra-articular and small incision low extra-articular LHBT amputation and fixation for SIS patients with long head tendinitis of biceps brachii.Methods:From December 2019 to December 2022,92 patients with ASES accompanied with tendini-tis of biceps brachii long head were selected in our hospital.Among them,45 patients were treated with high intra-articular LHBT amputation and fixation under arthroscopy(observation group A),and 47 patients were treated with low intra-articular LHBT amputation and fixation under intertrochanteric groove(observation group B).The scores of each dimension,total score and Constant of the University of California(UCLA)shoulder joint scoring system before and after treatment were compared.Results:After treatment,both UCLA scores of each dimension,patient satisfaction,and total scores were increased(P<0.05),but the differences in UCLA scores,patient satisfaction,and total scores before and after treatment in Group A were significantly lower(P<0.05).After treatment,Constant and ASES scores increased in both groups compared to before treatment(P<0.05),but the difference between the Constant and ASES scores of Group A before and after treatment is significantly lower(P<0.05).Compared with 95.74%,80.00%was significantly less effective(P<0.05).Conclusion:Compared with arthroscopic treatment of high-level intra-articular LHBT amputa-tion and fixation,small-incision low-level intra-articular LHBT amputation and fixation for SIS patients with long head tendinitis of biceps brachii can effectively promote the recovery of shoulder joint function and im-prove the clinical curative effect.