Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

Mid-term outcomes of microfragmented adipose tissue plus arthroscopic surgery for knee osteoarthritis:A randomized,activecontrol,multicenter clinical trial

BACKGROUND Osteoarthritis(OA)is the most prevalent form of degenerative whole-joint disease.Before the final option of knee replacement,arthroscopic surgery was the most widely used joint-preserving surgical treatment.Emerging regenerative therapies,such as those involving platelet-rich plasma,mesenchymal stem cells,and microfragmented adipose tissue(MFAT),have been pushed to the forefront of treatment to prevent the progression of OA.Currently,MFAT has been successfully applied to treat different types of orthopedic diseases.AIM To assess the efficacy and safety of MFAT with arthroscopic surgery in patients with knee OA(KOA).METHODS A randomized,multicenter study was conducted between June 2017 and November 2022 in 10 hospitals in Zhejiang,China.Overall,302 patients diagnosed with KOA(Kellgren-Lawrence grades 2-3)were randomized to the MFAT group(n=151,were administered MFAT following arthroscopic surgery),or the control group(n=151,were administered hyaluronic acid following arthroscopic surgery).The study outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC)score,the visual analog scale(VAS)score,the Lequesne index score,the Whole-Organ Magnetic Resonance Imaging Score(WORMS),and safety over a 24-mo period from baseline.RESULTS The changes in the WOMAC score(including the three subscale scores),VAS pain score,and Lequesne index score at the 24-mo mark were significantly different in the MFAT and control groups,as well as when comparing values at the posttreatment visit and those at baseline(P<0.001).The MFAT group consistently demonstrated significant decreases in the WOMAC pain scores and VAS scores at all follow-ups compared to the control group(P<0.05).Furthermore,the WOMAC stiffness score,WOMAC function score,and Lequesne index score differed significantly between the groups at 12 and 24 mo(P<0.05).However,no signicant between-group differences were observed in the WORMS at 24 mo(P=0.367).No serious adverse events occurred in both groups.CONCLUSION The MFAT injection combined with arthroscopic surgery treatment group showed better mid-term clinical outcomes compared to the control group,suggesting its efficacy as a therapeutic approach for patients with KOA.

Arthroscopic surgery for synovial chondroma of the subacromial bursa with non-traumatic shoulder subluxation complications:Two case reports

BACKGROUND Synovial chondromatosis is a disease originating from the synovium and characterized by the presence of metaplastic cartilaginous nodules in synovial cavities.The exact prevalence of synovial chondromatosis remains unknown,and the involvement of the shoulder joint is very rare.Synovial chondromatosis accompanied by subluxation of the humeral head without a history of trauma is rarely encountered,and to our knowledge,no published reports describe this condition.CASE SUMMARY We present two cases of synovial chondromatosis in the shoulder joint,accompanied by subluxation of the humeral head,in two arthroscopically managed adult patients.We performed arthroscopic labrum fixation and removal of the loose body from the shoulder joint.To identify primary and secondary categories,pathological analysis was arranged.Clinical and radiographic evaluations at the 1-mo follow-up were satisfactory.CONCLUSION The biomechanical function of the shoulder joint requires attention,especially following the detection of loose bodies,as observed with synovial chondroma occurring in rare sites.Arthroscopic management is successful in patients with synovial chondromatosis combined with shoulder subluxation.

Analgesic effects of low -dose trama dol after arthroscopic knee surgery

Objective To investigate analgesic effect of i ntra -articular low -dose tramadol a fter arthroscopic knee surgery.Methods60patients undergoing arthroscopic k nee surgery under lumbar anesthesia were randomly divided into intra -ar ticular injection of tramadol(TJ group),mulscle injection of tramadol(TM)and saline control group.Vision analog scoring was conducted under exte nsion of knee joint 8h and24h after drugs administration.Follow -up was done to observe unwanted e ffects 48h after surgery.Results Score of TJ group was significantly lower than those of other groups(P <0.05).No unwanted effects were found.Conclusion Intra -articular tramadol in low -dose could relieve operative pain.

Application of Tranexamic Acid in Shoulder Arthroscopic Surgery:A Randomised Controlled Trial

Objective To explore the optimal administration route of tranexamic acid(TXA)in shoulder arthroscopic surgery.Methods Patients undergoing arthroscopic rotator cuff repair were randomly divided into four groups:control group(without TXA treatment),intravenous group(TXA was intravenously administered 10 minutes before surgery),irrigation group(TXA was added to the irrigation fluid during subacromial decompression and acromioplasty),and intravenous plus irrigation group(TXA was applied both intravenously and via intra-articular irrigation).The primary outcome was visual clarity assessed with visual analog scale(VAS)score,and the secondary outcomes included irrigation fluid consumption and time to subacromial decompression and acromioplasty procedure.Results There were 134 patients enrolled in the study,including 33 in the control group,35 in the intravenous group,32 in the irrigation group,and 34 in the intravenous plus irrigation group.The median and interquartile range of VAS scores for the intravenous,irrigation,and intravenous plus irrigation groups were 2.70(2.50,2.86)(Z=-3.677,P=0.002),2.67(2.50,2.77)(Z=-3.058,P<0.001),and 2.91(2.75,3.00)(Z=-6.634,P<0.001),respectively,significantly higher than that of the control group[2.44(2.37,2.53)].Moreover,the control group consumed more irrigation fluid than the intravenous group,irrigation group,and intravenous plus irrigation group(all P<0.05).The intravenous plus irrigation group consumed less irrigation fluid than either the intravenous group or the irrigation group(both P<0.001).There was no difference in subacromial decompression and acromioplasty operative time among the four groups.Conclusion TXA applied both topically and systematically can improve intraoperative visual clarity,and the combined application is more effective.

Arthroscopic approach to the posterior compartment of the knee using a posterior transseptal portal

Arthroscopic surgery of the posterior compartment ofthe knee is difficult when only two anterior portals are used for access because of the inaccessibility of the back of the knee. Since its introduction, the posterior transseptal portal has been widely employed to access lesions in the posterior compartment. However, special care should be taken to avoid neurovascular injuries around the posteromedial, posterolateral, and transseptal portals. Most importantly, popliteal vessel injury should be avoided when creating and using the transseptal portal during surgery. Purpose of the present study is to describe how to avoid the neurovascular injuries during establishing the posterior three portals and to introduce our safer technique to create the transseptal portal. To date, we have performed arthroscopic surgeries via the transseptal portal in the posterior compartments of 161 knees and have not encountered nerve or vascular injury. In our procedure, the posterior septum is perforated with a 1.5-3.0-mm Kirschner wire that is protected by a sheath inserted from the posterolateral portal and monitored from the posteromedial portal to avoid popliteal vessel injury.

Absorbable implants in sport medicine and arthroscopic surgery:A narrative review of recent development

Over the past two decades,advances in arthroscopic and minimally invasive surgical techniques have led to significant growth in sports medicine surgery.Implants such as suture anchors,interference screws,and endo-buttons are commonly used in these procedures.However,traditional implants made of metal or inert materials are not absorbable,leading to complications that affect treatment outcomes.To address this issue,absorbable materials with excellent mechanical properties,good biocompatibility,and controlled degradation rates have been developed and applied in clinical practice.These materials include absorbable polymers,absorbable bioceramics,and absorbable metals.In this paper,we will provide a comprehensive summary of these absorbable materials from the perspective of clinicians,and discuss their clinical applications and related research in sport medicine.

后交叉韧带胫骨附着点撕脱骨折:关节镜治疗中的材料、植入物及内固定技术

背景:治疗后交叉韧带胫骨附着点撕脱骨折的最佳手术技术仍值得商榷。随着关节镜手术的应用与成熟,它在后交叉韧带胫骨附着点撕脱骨折的诊疗中有很大前景。目的:综述关节镜技术在后交叉韧带胫骨附着点撕脱骨折治疗中的应用与进展,包括不同关节镜治疗方法、手术入路、胫骨隧道设计、缝合材料选择以及内固定植入物选择等。方法:通过计算机对中国知网、PubMed、Web of Science及ScienceDirect等数据库中的相关文献进行检索,检索时间为2003年1月至2023年11月,中文检索词为“后交叉韧带,后十字韧带,撕脱骨折,关节镜”;英文检索词为“posterior cruciate ligament,avulsion,fracture,tibia,arthroscopic,operation,fixation,treatment”。共纳入97篇文献进行综述。结果与结论:关节镜技术提供了一种可靠的治疗方式来治疗后交叉韧带胫骨附着点撕脱骨折。根据入路、缝合材料类型以及用于缝合的入路和胫骨隧道数量等不同,关节镜技术可以分为关节镜下缝线固定结合自体移植物增强重建、关节镜下多交叉带缝合桥固定、关节镜下高强度缝线固定以及关节镜下直接前后缝合悬吊固定等几类。在各种研究中,常用的临床结果评估指标包括关节活动度、Lysholm评分、国际膝关节文献委员会评分及KT-2000关节测量仪差等,研究显示关节镜手术后末次随访时上述指标检测结果较术前显著改善,影像学随访结果显示关节镜手术都取得了令人满意的结果。在随访过程中,接受关节镜技术治疗后的各类交叉韧带胫骨附着点撕脱骨折患者都未出现严重并发症,例如创伤性关节炎、神经血管损伤、围手术期伤口感染、血栓形成以及骨折不愈合等。

Effects of different positions on rehabilitation after rotator cuff repair under shoulder arthroscopy

Objective Shoulder arthroscopic rotator cuff tear repair is currently the main treatment for full-thickness rotator cuff tears,and postoperative rehabilitation training is essential.However,pain and limitation of activity during the rehabilitation process will lead to poor results.Hence,identifying rehabilitation approaches is crucial.This study aimed to compare patient's rehabilitation outcomes and experience between rehabilitation in the supine position and in the standing position.Methods This prospective study included patients diagnosed with full-thickness rotator cuff tears who underwent shoulder arthroscopic double-row rivet repair at Sir Run Run Shaw Hospital,Zhejiang University School of Medicine from March 2019 to September 2021.The patients were randomly assigned to the standing rehabilitation exercise group(group A)and the supine rehabilitation exercise group(group B).All patients were followed up for 6 months to record and compare the visual analog scale(VAS)scores,shoulder range of motion,and rehabilitation compliance.Results Altogether,86 patients participated in the study,of whom 79 patients completed the 6-month follow-up.Groups A and B had 39 and 40 patients,respectively.Before operation,the VAS score,forward flexion and extension angle,and abduction angle were comparable between groups A and B.After operation,the patients in groups A and B all experienced a significant improvement in the VAS score,forward flexion and extension angle,and abduction angle(p<0.05).In addition,patients in group B had better VAS score(4.58±0.87 vs.5.21±1.13,p=0.0068;2.15±0.66 vs.2.51±0.51,p=0.0078;0.78±0.86 vs.1.33±0.81,p=0.0015),forward flexion and extension angle(109.30±2.87°vs.102.33±3.74°,p=0.0001;109.53±3.39°vs.104.18±2.76°,p=0.0001;125.22±6.05°vs.117.59±2.27°,p=0.0001),and abduction angle(91.78±2.77°vs.82.92±2.12°,p=0.0001;91.62±2.78°vs.82.82±1.45°,p=0.0001;109.48±3.37°vs.100.10±2.94°,p=0.0001)at 2 wk,6 wk and 6 m postoperatively.Conclusion After 6 months of follow-up,the patients who performed rehabilitation exercises in the supine position achieved better rehabilitation outcomes than those who performed rehabilitation exercises while standing.

Hip Arthroscopy in Children under the Age of Ten

Arthroscopic hip surgery has become an established diagnostic and therapeutic method for addressing different hip pathologies. This paper focuses on hip arthroscopy for treating hip disorders in children under the age of 10. Arthroscopic hip surgery was performed 30 times on 24 children to address various hip pathologies. Indications were septic arthritis, benign soft tissue tumors, traumatic and congenital hip dislocation, juvenile idiopathic arthritis and osteochondroma of the acetabulum. Diagnostic arthroscopy was technically feasible in all cases. All cases of septic arthritis were successful treated using arthroscopic lavage and antibiotics. In the miscellaneous cases (benign fibrous tumor, juvenile idiopathic arthritis, osteochondroma congenital hip dislocations and traumatic hip dislocation) 4 hips had additional open surgery including surgical dislocation with synovectomy, open reduction and stabilization of the fractured posterior rim of the acetabulum, acetabulopasty and open resection of an osteochondroma with acetabuloplasty. In conclusion arthroscopic hip surgery is an additional diagnostic and therapeutic method that is suitable for treating different hip pathologies in children under the age of 10. Primary treatment of septic arthritis can be done easy by hip arthroscopy. Using cannulated mini arthroscopic hip instruments (2.7 mm), the range of application can be expanded to include treatment of very young infants. Hip arthroscopy can reduce the need of open surgery but cannot replace bony procedures in hip surgery.

Hip Arthroscopy Has Acceptable Return to Sport Outcomes for the Elite Athlete

Intra-articular disorders of the hip in the elite athlete are common and potentially career threatening. Hip arthroscopy has been shown to be a safe and successful method of treating these conditions. This study examines the effectiveness of hip arthroscopy in facilitating an early return to professional level sport. We prospectively followed 65 professional athletes (mostly Australian Rules Football players) before and after hip arthroscopy using the Modified Harris Hip Score (MHS) and the Non-Arthritic Hip (NAH) Score. We followed them to the 1 year mark and recorded the time required for them to return to sport. Follow-up was achieved in 100% of patients. Intraoperative findings included femoroacetabular impingement, labral pathology and ligamentumteres injuries. Both MHS and NAH Scores showed highly statistically significant improvements up to the 1 year mark. All but 3 athletes returned to professional level sport. The mean return to sport time was 11.9 weeks. The use of arthroscopy to manage common intra-articular hip disorders in elite athletes is safe, effective and facilitates an early return to sport.

透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤的效果

目的分析透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤的效果。方法选择2020年1月至2021年12月南京市溧水区人民医院收治的72例水平撕裂型半月板损伤患者,按照随机数字表法将其分为对照组(36例)与研究组(36例)。对照组接受关节镜手术治疗,研究组在对照组的基础上采用透明质酸钠关节腔内注射,持续治疗5周。比较两组治疗前后膝关节Lysholm评分、国际膝关节评分委员会(IKDC)评分;比较两组临床疗效;比较两组治疗前后膝关节活动度;比较两组治疗前后血清白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)水平;记录两组治疗过程中并发症的发生情况。结果治疗后,两组Lysholm评分、IKDC评分、膝关节活动度高于治疗前,且研究组高于对照组(P<0.05)。研究组临床疗效优于对照组(P<0.05)。治疗后两组IL-1β、TNF-α水平低于治疗前,且研究组低于对照组(P<0.05)。两组并发症总发生率比较,差异无统计学意义(P>0.05)。结论透明质酸钠关节腔内注射联合关节镜手术治疗水平撕裂型半月板损伤效果显著,可减轻炎症反应,改善膝关节活动度与膝关节功能,且安全性良好。

脑电双频指数监测下腋路臂丛神经阻滞复合全身麻醉在肩关节镜手术中的应用效果

目的:探究脑电双频指数(BIS)监测下腋路臂丛神经阻滞复合全身麻醉在肩关节镜手术中的应用效果。方法:选择2020年1月—2023年1月在宁夏医科大学总医院、吴忠市人民医院进行肩关节镜手术的患者86例,应用随机数字表法将其分为对照组(采用BIS监测下锁骨上入路臂丛神经阻滞复合全身麻醉)及观察组(采用BIS监测下腋路臂丛神经阻滞复合全身麻醉),各43例。对比两组不同时刻[麻醉前(T_(0))、气管插管即刻(T_(1))、切皮时(T_(2))、拔管时(T_(3))]心率(HR)、平均动脉压(MAP)、BIS值;对比两组麻醉苏醒后及术后2、12 h疼痛评分[视觉模拟评分法(VAS)]、肌力评分;对比两组术中舒芬太尼用量;对比两组不良反应发生率。结果:T_(0)时,两组HR、MAP比较,差异均无统计学意义(P>0.05);T_(1)、T_(2)、T_(3)时,观察组HR、MAP均低于对照组,差异均有统计学意义(P<0.05);T_(0)、T_(1)、T_(2)时,两组BIS比较,差异均无统计学意义(P>0.05);观察组T_(3)时BIS高于对照组,差异有统计学意义(P<0.05)。观察组麻醉苏醒后及术后6、12 h的VAS评分均低于对照组,肌力评分均高于对照组,差异均有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计意义(P>0.05)。结论:BIS监测下腋路臂丛神经阻滞复合全身麻醉在肩关节镜手术中的麻醉效果显著,可稳定血流动力学,患者术后疼痛程度较轻,对肌力影响较小,安全性较高。

不同性别对日间关节镜手术患者瑞马唑仑使用剂量及术后恢复质量的影响

目的 探讨性别对日间关节镜手术患者瑞马唑仑使用剂量以及术后24 h恢复质量(QoR)的影响。方法 选择预约在日间手术中心进行关节镜半月板修复术的患者50例,按照性别分为两组,其中男25例(M组),女25例(F组)。本研究主要观察两组在麻醉诱导失去意识和术中维持瑞马唑仑剂量的区别,以及采用QoR-15量表、阿森斯失眠(AIS)量表观察性别对术后睡眠和24 h恢复质量的影响。结果M组患者失去意识时瑞马唑仑剂量为0.14(0.13,0.15) mg/kg,麻醉维持剂量为0.80(0.60,0.96)mg/(kg·h);F组患者失去意识时瑞马唑仑剂量为0.14(0.12,0.16) mg/kg,麻醉维持剂量为0.90(0.79,1.12)mg/(kg·h),两组患者失去意识与麻醉维持的瑞马唑仑剂量差异均无统计学意义(P> 0.05)。两组对术后第1天睡眠的AIS总分影响差异无统计学意义(P> 0.05),但女性患者较男性患者更易发生低血压和PONV,术后比期望中更早醒及QoR-15总分、生理舒适度分数降低,差异有统计学意义(P <0.05)。结论 性别对日间关节镜患者瑞马唑仑麻醉诱导剂量及麻醉维持剂量影响较小,但女性患者术后睡眠清醒时间更早,男性患者术后24 h恢复质量较高。

针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响

目的 分析针对性康复护理对肩袖损伤行关节镜手术患者术后肩关节功能恢复及护理满意度的影响。方法 选取2020年6月至2023年6月于厦门大学附属中山医院接受关节镜手术治疗的肩袖损伤患者100例,根据随机数字表法分为两组,对照组(50例)采取常规护理方法,观察组(50例)在此基础上施以针对性康复护理干预,对比两组的肩关节功能(欧美肩关节评分系统C-M)、生活质量(SF-36)、并发症发生率及护理满意度。结果 术后5个月时,观察组的C-M评分、SF-36评分均较对照组高(P <0.05);观察组并发症发生率较对照组更低(4.00%vs. 16.00%,P <0.05);观察组护理满意度较对照组更高(98.00%vs. 82.00%,P <0.05)。结论 将针对性康复护理用于肩袖损伤行关节镜手术患者,能使其肩关节功能得到更好恢复,减少并发症发生,提高生活质量与护理满意度。

静脉注射联合关节腔灌注氨甲环酸对肩关节镜肩袖修补术后患者的作用效果

目的 探究静脉注射联合关节腔灌注氨甲环酸对肩关节镜肩袖修补术后患者的影响。方法 收集医院2020年2月至2022年11月收治的84例接受肩关节镜肩袖修补术患者的临床资料。依照术中止血干预方式分为观察组(56例,静脉注射联合关节腔灌注氨甲环酸)和对照组(28例,氨甲环酸静脉注射)。比较两组血红蛋白、手术出血量、手术时间、肩关节肿胀情况、疼痛程度、肩关节功能、并发症、白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)水平。结果 术后1 d两组血红蛋白下降,观察组高于对照组(P<0.001)。两组手术出血量、手术时间相比,差异有统计学意义(P<0.001)。两组肩关节周径组间、时间、交互效应有统计学意义(P<0.05)。术后1、2 d,两组疼痛评分差异有统计学意义,且观察组低于对照组(P<0.05);两组术后2 d的疼痛评分均低于术后1 d(P<0.001)。术后1个月两组肩关节功能评分均高于术前,观察组高于对照组(P<0.001)。两组术后IL-1β、TNF-α、MMP-3均降低,且观察组低于对照组(P<0.001)。结论 静脉注射联合关节腔灌注氨甲环酸应用于肩关节镜肩袖修补手术中能够有效发挥止血作用,减轻炎症反应,缓解患者疼痛,改善肩关节功能,相对安全。

星状神经节阻滞对肩关节镜手术沙滩椅位脑血流动力学改变的影响研究

目的研究星状神经节阻滞对肩关节镜手术沙滩椅位脑血流动力学改变的影响。方法取择期行沙滩椅位肩关节镜手术患者40例,随机分为治疗组T组和对照组C组各20例,T组术前行超声引导下SGB,对比两组患者术中生命体征、BIS值、脑氧合饱和度(rSO_(2))、不同时段大脑中动脉血流频谱图像、术后7 d ULCA评分、MMSE评分、RBANS总分,将两组数据进行统计学处理分析。结果T组比C组患者术中生命体征变化波动较小,差异有统计学意义(P<0.05)。不同时段rSO_(2)基本保持在相同水平,差异无统计学意义(P>0.05);T组患者大脑中动脉血流流速比C组要低,但血管内径要大,根据公式得出T组患者在不同时间段血流量都要比C组同时段的多,比较差异有统计学意义(P<0.05)。两组术后7 d ULCA评分、MMSE评分、RBANS总分对比T组明显较高,差异有统计学意义(P<0.05)。结论对沙滩椅位行肩关节镜手术的患者术前实施星状神经阻滞术具有增加脑血供及脑保护作用且对患者术后关节功能恢复有良好的促进作用,有临床推广实用价值。

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

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。

手术沙滩椅体位摆置标准作业程序的建立及应用

目的研究手术沙滩椅体位(beach chair position,BCP)摆置标准作业程序(standard operation procedure,SOP)的建立及应用。方法采用方便抽样的方法,选取2020年10—12月厦门大学附属第一医院收治的16例肩关节镜手术患者为对照组,以对等原则选取2021年1—3月收治的16例患者为观察组。对照组按常规手术体位摆置;观察组按BCP摆置SOP实施摆置。比较2组摆置时间、团队协作熟悉度及医生满意度,并就对手术BCP摆置SOP进行评价。结果观察组手术体位摆置时间为(471.81±52.41)s,短于对照组的(719.13±66.94)s(P<0.05);观察组手术医生的满意度高于对照组,手术团队协作熟悉度评分高于对照组,差异有统计学意义(P<0.05)。2组麻醉医生满意度比较,差异无统计学意义(P>0.05)。团队成员对手术BCP摆置SOP评价认可度均较高。结论手术BCP摆置SOP的建立及应用使手术体位护理规范化、标准化、同质化,有效提高手术室护理质量和工作效率。