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Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery 被引量:1
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作者 Di-Ping Cao Lei Yin +1 位作者 Yi-Fei Wang Bing-Li Liu 《World Journal of Clinical Cases》 SCIE 2024年第19期3767-3775,共9页
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... 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. 展开更多
关键词 Multidisciplinary team model Integrated traditional Chinese medicine and Western medicine Rotator cuff injury ARTHROSCOPY Arthroscopic surgery
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Effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries
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作者 Zhi-Ying Chen Meng-Hua Wang Zhong Ye 《World Journal of Clinical Cases》 SCIE 2024年第21期4582-4589,共8页
BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroa... BACKGROUND The rotator cuff is located below the acromion and deltoid muscles and comprises multiple tendons that wrap around the humeral head,maintaining shoulder joint stability.AIM To explore the effect of electroacupuncture combined with rehabilitation techniques on shoulder function in patients with rotator cuff injuries.METHODS We selected 97 patients with rotator cuff injuries treated in the People's Hospital of Yuhuan from February 2020 to May 2023.Patients were grouped using the envelope method.RESULTS After treatment,the study group’s treatment effective rate was 94.90%(46/49 patients),significantly higher than that in the control group(79.17%,38/48 cases;P<0.05).Before treatment,there was no difference in Constant Murley Score(CMS)scores,shoulder mobility,or 36-Item Short Form Health Survey(SF-36)scale scores(P>0.05).Compared with those before treatment,the CMS scores(including pain,daily living ability,shoulder mobility,and muscle strength),all aspects of shoulder mobility(forward flexion,posterior extension,external rotation,internal rotation),and SF-36 scale scores(including physiological,psychological,emotional,physical,vitality,and health status)were higher in both groups after treatment and significantly higher in the study group(P<0.05).There was no difference in the occurrence of complications between the two treatment groups(P>0.05).CONCLUSION Electroacupuncture combined with rehabilitation techniques has a good treatment effect on patients with rotator cuff injuries,helps accelerate the recovery of shoulder function,improves the quality of life,and is highly safe. 展开更多
关键词 Electroacupuncture therapy Rehabilitation technique Rotator cuff injury Shoulder joint function
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Therapeutic Effect of Single-row Technique and Nocompression Sputum in the Treatment of Post Small and Medium Rotator Cuff Injury under Shoulder Arthroscopy
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作者 Pan Liu 《Journal of Clinical and Nursing Research》 2019年第6期37-41,共5页
Objective.To investigate the clinical effect of single-row fixation and non-conjunction compression in the treatment of post small and medium rotator cuff injuries under arthroscopy.Methods.Forty-five patients admitte... Objective.To investigate the clinical effect of single-row fixation and non-conjunction compression in the treatment of post small and medium rotator cuff injuries under arthroscopy.Methods.Forty-five patients admitted to our department from June 2018 to May 2019 were enrolled in the study.32 patients in the single-row fixed-group and 13 patients in the non-conjunctival group were randomly assigned.The VAS,ASES,and UCLA scores of the two groups were compared before surgery,one month,three months,and six months after surgery[1].Results.The VAS,ASES,and UCLA scores were significantly higher in those two groups other than the preoperative group.The scores of the two groups were gradually improved from one month,three months,and six months respectively after surgery.At one month,the scores of those two groups were statistically significant(P<0.05),but there was no significant difference between the two groups at three months and six months(P>0.05).Conclusion.Under arthroscopy,the single-row fixation technique and the non-conjunction compression method were used to treat post small and medium rotator cuff injuries.The effect is very significant.In particular,the no-knot sputum method has a significant improvement in restoring postoperative pain,joint activity and joint strength. 展开更多
关键词 ROTATOR cuff injury POST classification Shoulder ARTHROSCOPY SINGLE ROW method.
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Assessing clinical and patient reported outcomes of Sironix suture anchors in rotator cuff and Bankart repair surgeries
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作者 Puthumanapully Vinod Kumar Subin Sugath +3 位作者 Vijay Mohan Ashok Kumar Moharana Sachin Angrish Deepak TS 《World Journal of Orthopedics》 2024年第12期1183-1190,共8页
BACKGROUND Rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of life.Arthroscopic rotator cuff repair and Bankart repair has become the standard treatment for restoring function... BACKGROUND Rotator cuff tears and Bankart lesions significantly affect shoulder function and quality of life.Arthroscopic rotator cuff repair and Bankart repair has become the standard treatment for restoring function and reducing pain.Recent advancements include new suture anchor technologies,such as the Sironix suture anchor known for its biomechanical strength and promising outcomes.However,there are limited real-world data on its effectiveness and safety,particularly in the Indian population.AIM To evaluate the effectiveness and safety of Sironix suture anchors in rotator cuff and Bankart repair surgeries.METHODS Sixty participants underwent surgery between January 2021 and December 2022,and demographic data and postoperative outcomes were collected through retrospective reviews and telephonic interviews.Validated scales,including the PENN Shoulder Score(PSS),Disabilities of the Arm,Shoulder,and Hand(DASH)score,and Single Assessment Numeric Evaluation(SANE),were utilized for assessment.RESULTS Treatment with Sironix suture anchor devices,including Ceptre Knotted UHMWPE Suture Titanium Anchor,Spyke Knotted UHMWPE Suture Peek Anchor,Stativ Knotted UHMWPE Suture Anchor,and Viplok Knotless Peek Screw Anchor with Titanium Tip,revealed no repair failures.Participants demonstrated high satisfaction and functional improvement,as evidenced by the mean Quick DASH score(32.01)and PSS(71.65)and the satisfactory SANE scores for both injured joints(74.33)and non-injured(83.67)shoulder joints.CONCLUSION The study yielded favorable outcomes for rotator cuff tear repair and Bankart repair.No repair failures were observed,supporting the safety and efficacy of these devices in shoulder injury management. 展开更多
关键词 Arthroscopic Bankart repair Rotator cuff repair Shoulder injuries Suture anchor Treatment outcome
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生物3D打印仿生支架促进肩袖损伤后的愈合
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作者 徐杰 酒精卫 +1 位作者 刘海峰 赵斌 《中国组织工程研究》 CAS 北大核心 2025年第22期4761-4770,共10页
背景:大多数肩袖损伤发生于冈上肌腱,由于肌腱组织缺少血管以及肩袖复杂的解剖结构,临床治疗效果非常有限。组织工程技术和干细胞生物学的快速发展为提高肌腱修复质量带来了新的希望。目的:通过生物3D打印技术制备人脐带间充质干细胞/... 背景:大多数肩袖损伤发生于冈上肌腱,由于肌腱组织缺少血管以及肩袖复杂的解剖结构,临床治疗效果非常有限。组织工程技术和干细胞生物学的快速发展为提高肌腱修复质量带来了新的希望。目的:通过生物3D打印技术制备人脐带间充质干细胞/甲基丙烯酸酐化明胶复合支架,观察该支架修复肩袖损伤的效果。方法:(1)体外细胞实验:制备明胶微载体,将人脐带间充质干细胞接种于明胶微载体表面构建组织工程化干细胞。制备甲基丙烯酸酐化明胶水凝胶打印墨水,使用甲基丙烯酸酐化明胶水凝胶打印墨水重悬组织工程化干细胞,放入3D打印机的生物墨水容器中进行打印,蓝光照射固化5 min后即得人脐带间充质干细胞/甲基丙烯酸酐化明胶复合支架。通过死活染色、CCK-8实验检测支架内人脐带间充质干细胞的活性。(2)动物体内实验:采用随机区组设计方法将24只SD大鼠随机4组,每组6只:正常组不进行任何处理,肩袖损伤组、单纯支架组、细胞支架组建立冈上肌腱撕裂的肩袖损伤模型,单纯支架组、细胞支架组造模后分别将甲基丙烯酸酐化明胶支架、人脐带间充质干细胞/甲基丙烯酸酐化明胶复合支架植入肌腱损伤处。术后4周,分别进行大鼠行为学测试及肩袖冈上肌腱组织学病理组织形态观察。结果与结论:(1)体外细胞实验:死活染色结果显示,明胶微载体可减轻3D打印过程对人脐带间充质干细胞造成的损伤,随着培养时间的延长,支架内的人脐带间充质干细胞存活率升高;CCK-8实验结果显示,随着培养时间的延长,支架内的人脐带间充质干细胞活性无明显变化。(2)动物体内实验:行为学测试结果显示,相较于肩袖损伤组、单纯支架组,细胞支架组大鼠四肢运动功能明显改善;肩袖冈上肌腱苏木精-伊红与Masson染色结果显示,相较于肩袖损伤组、单纯支架组,细胞支架组肌纤维排列较规律,无明显的炎性细胞浸润,胶原容积百分比降低;免疫荧光染色结果显示,相较于肩袖损伤组、单纯支架组,细胞支架组肩袖冈上肌腱内白细胞介素6、肿瘤坏死因子α蛋白表达明显降低。(3)结果表明,生物3D打印的人脐带间充质干细胞/甲基丙烯酸酐化明胶复合支架可促进肩袖损伤组织修复再生。 展开更多
关键词 肩袖损伤 冈上肌腱损伤 人脐带间充质干细胞 细胞治疗 组织工程化干细胞 生物支架 甲基丙烯酸化明胶 生物3D打印
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关节镜下肩袖撕裂修补后再撕裂的非手术性影响因素
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作者 黄子帅 王健 《中国组织工程研究》 CAS 北大核心 2025年第27期5914-5923,共10页
背景:目前肩关节镜下肩袖修补术已经成为治疗肩袖撕裂的主要方法。肩关节镜下肩袖修补后肩袖再次发生撕裂是多因素作用的结果,术后发生再撕裂是当前研究热点。目前针对术后肩袖再撕裂非手术影响因素的全面性综述较少。目的:探究导致肩... 背景:目前肩关节镜下肩袖修补术已经成为治疗肩袖撕裂的主要方法。肩关节镜下肩袖修补后肩袖再次发生撕裂是多因素作用的结果,术后发生再撕裂是当前研究热点。目前针对术后肩袖再撕裂非手术影响因素的全面性综述较少。目的:探究导致肩关节镜下肩袖修补后肩袖再撕裂的非手术性危险因素,为临床干预提供理论指导,减少术后肩袖再撕裂的发生。方法:第一作者在2023年5月进行检索,并在2023年5月至2024年7月补充文献。检索PubMed、Web of Science和中国知网关于关节镜修复后肩袖再撕裂的非手术危险因素的观察性对比研究,检索采用主题词与自由词相结合的方式,文献检索时限为2000-01-01/2024-07-01。结果与结论:①按照纳入和排除标准,共采纳70篇文献进行综述分析;②此文综述了肩袖修补术后再撕裂的各种非手术因素,包括人口与社会因素、解剖因素、肩袖质量、术后康复、肩袖撕裂类型、手术时机等;③年龄增长与肩袖退化性变化相关,增加再撕裂的可能性;糖尿病和高血脂等代谢性疾病可通过影响局部血液供应和组织质量间接影响修复质量和稳定性;④临界肩角和关节盂倾斜度被认为是影响再撕裂风险的关键解剖学参数,临界肩角>35°的患者再撕裂风险显著增加,关节盂倾斜度较大会改变肩部的生物力学环境,增加撕裂风险;⑤肩袖肌腱的质量,如脂肪浸润和肌肉回缩及撕裂类型(例如大的或复杂的撕裂形状)也影响再撕裂率;⑥术后康复对再撕裂也有显著影响,包括康复的时间和方式,适度的活动有助于改善血液循环和肌腱愈合,但过早或过度的活动可能增加撕裂风险,定制个性化康复方案在预防肩袖再撕裂中具有重要作用;⑦虽然手术技术对肩袖修复的成功至关重要,但这些非手术因素同样影响术后结果和再撕裂风险,应在临床实践中得到充分考虑。 展开更多
关键词 肩袖损伤 肩袖再撕裂 非手术因素 肩峰形态 肩袖撕裂类型 术后康复 工程化组织构建
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温针灸联合康复训练治疗肩袖损伤的疗效观察
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作者 肖鸿伟 谷俊刚 +3 位作者 林荣 曾晓霞 童华卿 何坚 《中医康复》 2025年第2期10-15,共6页
目的:观察温针灸结合康复训练治疗肩袖损伤的疗效。方法:选取2019年1月~2020年1月在福建中医药大学附属康复医院门诊就诊的肩袖损伤患者70例,按照随机数字表法分为治疗组和对照组各35例。对照组予以康复训练治疗,治疗组在对照组基础上... 目的:观察温针灸结合康复训练治疗肩袖损伤的疗效。方法:选取2019年1月~2020年1月在福建中医药大学附属康复医院门诊就诊的肩袖损伤患者70例,按照随机数字表法分为治疗组和对照组各35例。对照组予以康复训练治疗,治疗组在对照组基础上联合温针灸治疗,疗程均为14天。比较两组治疗前后疼痛视觉模拟量表(VAS)评分、等速肌力测试速度30°/s和60°/s时肩关节峰力矩、患侧与健侧峰力矩差值比及肩关节主动肌与拮抗肌峰力矩比的变化情况。结果:与治疗前比较,两组治疗后的疼痛VAS评分均显著降低(P<0.05),与对照组治疗后比较,治疗组疼痛VAS评分较显著降低(P<0.05)。肩关节等速肌力测试结果显示,与治疗前相比,两个角速度下(角速度为30°/s和60°/s),治疗后肩关节各动作下峰力矩增大、患侧与健侧峰力矩差值比降低。相比于对照组,治疗组肩关节前屈、后伸、外展时峰力矩(角速度30°/s时)及内收峰力矩(角速度60°/s时)表现出更明显的增加(P<0.05)。治疗组治疗后患侧与健侧肩关节前屈、后伸、内收、外展时峰力矩差值比与治疗前比降幅更大,差异有统计学意义(P<0.05),内外旋未见显著差异(P>0.05)。对照组患侧与健侧肩关节各个动作峰力矩差值治疗前后未见显著差异(P>0.05)。两个角速度下,治疗组和对照组做各个动作时,肩关节主动肌与拮抗肌峰力矩比约等于1;治疗后,肩关节前屈、后伸、内收、外展、内外旋时主动肌与拮抗肌峰力矩比差异无统计学意义(P>0.05)。结论:温针灸结合康复训练能有效减轻肩袖损伤患者的疼痛症状,促进肩关节肌肉力量恢复,改善肩关节功能,值得临床运用与推广。 展开更多
关键词 肩袖损伤 温针灸 康复训练 等速肌力测试 疼痛 峰力矩
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血小板衍生生长因子DD对人肌腱源性干细胞增殖和多向分化能力的影响
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作者 文华伟 张青松 +3 位作者 汤明 李亚楠 谈鸿飞 方禹舜 《中国组织工程研究》 CAS 北大核心 2025年第31期6649-6655,共7页
背景:慢性肩袖损伤常伴有肌腱退变和肌腱干细胞功能受损,血小板衍生生长因子DD作为一种重要的细胞因子,对干细胞增殖和分化具有调节作用。目的:探讨血小板衍生生长因子DD对人慢性肩袖损伤组织来源肌腱干细胞增殖和多向分化能力的影响。... 背景:慢性肩袖损伤常伴有肌腱退变和肌腱干细胞功能受损,血小板衍生生长因子DD作为一种重要的细胞因子,对干细胞增殖和分化具有调节作用。目的:探讨血小板衍生生长因子DD对人慢性肩袖损伤组织来源肌腱干细胞增殖和多向分化能力的影响。方法:获取人体慢性肩袖损伤组织标本并体外分离培养肌腱干细胞,免疫荧光染色观察细胞的骨架形态,流式检测肌腱干细胞表型表达。将肌腱干细胞分成2组:对照组不进行任何干预,血小板衍生生长因子DD组以5μg/mL血小板衍生生长因子DD干预,通过细胞增殖实验和三系分化实验评估血小板衍生生长因子DD对肌腱干细胞增殖和多向分化能力的影响。结果与结论:①血小板衍生生长因子DD组EdU阳性细胞数量较对照组显著增加(P<0.05),且肌腱干细胞更早进入快速增殖期,细胞呈对数增长;②血小板衍生生长因子DD组油红O染色、阿利新蓝染色、茜素红染色阳性面积较对照组明显增大(P<0.05);③上述结果表明,血小板衍生生长因子DD显著促进肌腱干细胞的增殖和成脂、成骨、成软骨分化。 展开更多
关键词 肌腱干细胞 肌腱源性干细胞 血小板衍生生长因子DD 肩袖损伤 肩袖修复 工程化干细胞
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Functional outcomes of traumatic and non-traumatic rotator cuff tears after arthroscopic repair 被引量:10
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作者 José Jorge Kitagaki Abechain Glaydson Gomes Godinho +3 位作者 Fabio Teruo Matsunaga Nicola Archetti Netto Julia Pozzetti Daou Marcel Jun Sugawara Tamaoki 《World Journal of Orthopedics》 2017年第8期631-637,共7页
AIM To compare the functional outcomes of traumatic and non-traumatic rotator cuff tears after arthroscopic repair. METHODS Eighty-seven patients with rotator cuff tears following arthroscopic treatment were divided i... AIM To compare the functional outcomes of traumatic and non-traumatic rotator cuff tears after arthroscopic repair. METHODS Eighty-seven patients with rotator cuff tears following arthroscopic treatment were divided into traumatic and non-traumatic tear groups. Postoperative muscle strength and outcomes using the modified University of California, Los Angeles score were evaluated. Sex, age, affected limb and dominant limb were correlated between groups. Muscle strength of the repaired and unaffected shoulders was compared. Rotator cuff injury size was measured. RESULTS Of the 87 patients who underwent rotator cuff repairs, 35 had traumatic tears and 52 had non-traumatic tears. In patients with non-traumatic tears, the average age was 59 years, 74.5% were female, 96.1% were righthand dominant and 92.3% had their dominant shoulder affected. Patients with traumatic tears were 59.5 yearsold on average, 51.4% were female, 91.4% were righthand dominant and 88.5% had their dominant shoulder affected. No difference existed in the mean modified University of California, Los Angeles score between patients with traumatic tears(33.7) compared with those with non-traumatic tears(32.8). No strength differences were observed between groups: The strength difference between the non-affected and affected sides was 1.21 kg in the non-traumatic group and 1.39 kg in the traumatic group(P = 0.576), while the strength ratio between the non-affected/affected sides was 0.805 in the nontraumatic group and 0.729 in the traumatic group(P = 0.224). CONCLUSION The functional results of traumatic rotator cuff repairs are similar to non-traumatic tears. Both outcomes are satisfactory. 展开更多
关键词 ROTATOR cuff Shoulder pain ARTHROSCOPY TENDON injuries ORTHOPEDICS
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Combination therapy using evening primrose oil and electrical stimulation to improve nerve function following a crush injury of sciatic nerve in male rats 被引量:7
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作者 Omid Badri Parviz Shahabi +4 位作者 Jalal Abdolalizadeh Mohammad Reza Alipour Hadi Veladi Mehdi Farhoudi Mohsen Sharif Zak 《Neural Regeneration Research》 SCIE CAS CSCD 2017年第3期458-463,共6页
Peripheral nerve injuries with a poor prognosis are common.Evening primrose oil(EPO) has beneficial biological effects and immunomodulatory properties.Since electrical activity plays a major role in neural regenerat... Peripheral nerve injuries with a poor prognosis are common.Evening primrose oil(EPO) has beneficial biological effects and immunomodulatory properties.Since electrical activity plays a major role in neural regeneration,the present study investigated the effects of electrical stimulation(ES),combined with evening primrose oil(EPO),on sciatic nerve function after a crush injury in rats.In anesthetized rats,the sciatic nerve was crushed using small haemostatic forceps followed by ES and/or EPO treatment for 4 weeks.Functional recovery of the sciatic nerve was assessed using the sciatic functional index.Histopathological changes of gastrocnemius muscle atrophy were investigated by light microscopy.Electrophysiological changes were assessed by the nerve conduction velocity of sciatic nerves.Immunohistochemistry was used to determine the remyelination of the sciatic nerve following the interventions.EPO + ES,EPO,and ES obviously improved sciatic nerve function assessed by the sciatic functional index and nerve conduction velocity of the sciatic nerve at 28 days after operation.Expression of the peripheral nerve remyelination marker,protein zero(P0),was increased in the treatment groups at 28 days after operation.Muscle atrophy severity was decreased significantly while the nerve conduction velocity was increased significantly in rats with sciatic nerve injury in the injury + EPO + ES group than in the EPO or ES group.Totally speaking,the combined use of EPO and ES may produce an improving effect on the function of sciatic nerves injured by a crush.The increased expression of P0 may have contributed to improving the functional effects of combination therapy with EPO and ES as well as the electrophysiological and histopathological features of the injured peripheral nerve. 展开更多
关键词 nerve regeneration peripheral nerve injury sciatic nerve injury evening primrose oil electrical stimulation sciatic functional index cuff electrode neural regeneration
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Aberrant Rotator Cuff Muscles: Coexistence of Triple-Tailed Teres Minor and Bi-Formed Infraspinatus (Major and Minor)
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作者 James Olumide Ashaolu Oladipo Olayemi Abimbola +1 位作者 Victor Okoliko Ukwenya Magnus Adebo Thomas 《Forensic Medicine and Anatomy Research》 2015年第1期20-24,共5页
The teres minor and infraspinatus muscles bear a close anatomical relationship in the posterior aspect of the scapula and constitute part of the rotator cuff muscles. Although there are only occasional reports of vari... The teres minor and infraspinatus muscles bear a close anatomical relationship in the posterior aspect of the scapula and constitute part of the rotator cuff muscles. Although there are only occasional reports of variations of the rotator cuff muscles, this paper reports the first combined occurrence of triple-tailed teres minor and infraspinatus muscle possessing two distinct parts, infraspinatus major and minor which are of clinical and sporting importance. Aberrant variations of rotator cuff muscles need to be brought to the knowledge of radiologists, surgeons and anatomists. 展开更多
关键词 ROTATOR cuff injury Teres MINOR MUSCLE INFRASPINATUS MUSCLE Anatomical Variation
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Predictors of clinical outcomes after non-operative management of symptomatic full-thickness rotator cuff tears
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作者 Christopher Bush Joel J Gagnier +2 位作者 James Carpenter Asheesh Bedi Bruce Miller 《World Journal of Orthopedics》 2021年第4期223-233,共11页
BACKGROUND Previous studies have shown that non-surgical management can be an effective treatment strategy for many patients with rotator cuff tears.Despite the prevalence of rotator cuff disease,few studies have exam... BACKGROUND Previous studies have shown that non-surgical management can be an effective treatment strategy for many patients with rotator cuff tears.Despite the prevalence of rotator cuff disease,few studies have examined the patient and tear related factors that predict outcomes of nonsurgical management in this cohort of patients.AIM To identify factors that are associated with changes in patient reported outcomes over time in individuals with full-thickness rotator cuff tears treated without surgery.METHODS A cohort of 59 patients who underwent non-surgical management of full thickness rotator cuff tears with a minimum of 1-year follow-up were identified from our institutional registry.Patient demographics,comorbidities and tear characteristics were collected at initial presentation.Outcome measures were collected at baseline and at each clinical follow-up,which included Western Ontario Rotator Cuff(WORC)index,American Shoulder and Elbow Surgeons score,Visual Analog Scale for pain and Single Assessment Numerical Evaluation.Multi-and univariate regression analyses were used to determine the impact of each patient and tear related variable on final WORC scores and change in WORC scores throughout the study.RESULTS In this non-surgical cohort,all patient-reported outcome measures significantly improved compared to baseline at 1 and 2-year follow-up.There was no significant difference in outcomes between 1 and 2 years.The average improvement surpassed the published minimal clinically important differences values for WORC,American Shoulder and Elbow Surgeons,Visual Analog Scale pain and Single Assessment Numerical Evaluation scores.Regression analysis identified female gender(β=-19.88,P=0.003),smoking(β=-29.98,P=0.014)and significant subscapularis fatty infiltration(β=-15.35,P=0.024)as predictors of less favorable WORC scores at 1 year,and female gender(β=-19.09,P=0.015)alone as a predictor of lower WORC scores at 2 years.Patients with symptom duration greater than 1 year at presentation reported less improvement in WORC scores at 1-year follow-up(β=-14.63,P=0.052)and patients with traumatic tears reported greater improvements in WORC scores at 2-year follow-up(β=17.37,P=0.031).CONCLUSION Patients with full thickness rotator cuff tears can achieve and maintain clinically meaningful benefit from non-surgical management through 2-year follow-up.Female patients,smokers,and those with significant subscapularis fatty infiltration tend to have lower overall WORC scores at 1-year follow-up,and females also have lower WORC scores at 2-year follow-up.Patients presenting with symptoms greater than 1 year had less clinical improvement at 1-year follow-up,and those with traumatic tears had greater clinical improvement at 2-year follow-up. 展开更多
关键词 Rotator cuff tear Conservative treatment Patient reported outcome measures Shoulder injuries Shoulder pain
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Critical importance of tracheal tube cuff pressure management
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作者 Taoyuan Robert Feng Ying Ye D John Doyle 《World Journal of Anesthesiology》 2015年第2期10-12,共3页
The ideal range for tracheal tube cuff pressures is usually taken to be between 20 to 30 cm H2 O. This is easily measured with a cuff pressure manometer and should be measured in each instance. The importanceof trache... The ideal range for tracheal tube cuff pressures is usually taken to be between 20 to 30 cm H2 O. This is easily measured with a cuff pressure manometer and should be measured in each instance. The importanceof tracheal tube cuff pressures is highlighted by the spectrum of airway complications that can occur with incorrect cuff pressures. High cuff pressures can result in complications ranging from sore throat and hoarseness to tracheal stenosis, necrosis, and even rupture. In such cases, the postulated causative factor is diminished blood flow to tracheal mucosa due to excessive cuff pressure on the tracheal wall. This hypothesized ischemic injury then produces healing fibrosis months or even years later. On the other hand, cuff pressures that are too low place the patient at risk for aspiration of gastric contents and consequently, aspiration pneumonitis and pneumonia. This is why the authors recommend that cuff pressures be measured following all intubations. 展开更多
关键词 TRACHEAL tube cuff pressure TRACHEAL injury TRACHEAL STENOSIS PATIENT safety INTUBATION
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肩关节镜下双排缝合桥技术治疗老年肩袖损伤46例 被引量:3
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作者 陈勇 庄全魁 +3 位作者 白亮 李杨 孟勇 王叶密 《安徽医药》 CAS 2024年第2期330-334,共5页
目的 探讨肩关节镜下双排缝合桥修复手术对老年肩袖损伤病人疼痛、手臂与肩部功能障碍(DASH)评分及再撕裂发生率的影响。方法 回顾性分析2018年8月至2020年2月阜阳市第二人民医院收治的89例老年肩袖损伤病人的临床资料,依照手术方法的... 目的 探讨肩关节镜下双排缝合桥修复手术对老年肩袖损伤病人疼痛、手臂与肩部功能障碍(DASH)评分及再撕裂发生率的影响。方法 回顾性分析2018年8月至2020年2月阜阳市第二人民医院收治的89例老年肩袖损伤病人的临床资料,依照手术方法的不同划分成对照组(肩关节镜下单排铆钉固定)、治疗组(肩关节镜下双排缝合桥修复手术),分别为43例、46例。于术前、术后1年采用视觉模拟评分法(VAS)评定患肩疼痛度,采用手臂与肩部功能障碍(DASH)评分量表评定肩关节功能,测量患肩关节前屈、外展活动度,并统计两组1年内再撕裂发生率。通过logistic回归分析确定病人术后再撕裂发生的影响因素。结果 术后1年两组不同撕裂程度病人VAS、DASH评分及患肩关节前屈、外展活动度与同组术前相比均明显改善(均P<0.05),术后两组轻度撕裂病人上述指标改善情况比较差异无统计学意义(均P>0.05),而治疗组中、重度撕裂病人上述指标改善情况均明显较对照组优(均P<0.05);治疗组再撕裂发生率4.35%明显较对照组的23.26%低(P<0.05);年龄、手术方式是病人术后再撕裂发生的影响因素(均P<0.05)。结论 对老年肩袖损伤病人实施肩关节镜下双排缝合桥修复手术,可有效改善患肩疼痛及功能,显著降低再撕裂发生率。 展开更多
关键词 肩袖损伤 肩关节镜 双排缝合桥技术 老年人
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MRI诊断肩袖损伤及撕裂程度的临床应用观察 被引量:1
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作者 潘小文 高艳 +2 位作者 但倩 董晚亭 万趸 《河北医学》 CAS 2024年第6期951-955,共5页
目的:探究MRI在肩袖损伤诊断及撕裂程度的评估中的应用效果。方法:回顾性分析我院183例肩部损伤患者资料,所有患者均行核磁共振成像(MRI)检查,以关节镜检查为金标准,探究MRI对肩袖损伤的诊断价值,对肩袖不同肌腱损伤及撕裂程度的检出情... 目的:探究MRI在肩袖损伤诊断及撕裂程度的评估中的应用效果。方法:回顾性分析我院183例肩部损伤患者资料,所有患者均行核磁共振成像(MRI)检查,以关节镜检查为金标准,探究MRI对肩袖损伤的诊断价值,对肩袖不同肌腱损伤及撕裂程度的检出情况,分析MRI与关节镜测量肩袖全层撕裂肌腱撕裂尺寸偏差情况。结果:经关节镜检查,183例患者肩袖损伤阳性136例,阴性47例,MRI检查134例阳性,49例阴性,诊断敏感度95.59%(130/136),特异度91.49%(43/47),准确度为94.54%(173/183),阳性预测值为97.01%(130/134),阴性预测值87.76%(43/49),Kappa值为0.859。183例患者关节镜共诊断373处损伤,其中冈上肌腱136处,冈下肌腱122处,肩胛下肌腱115处。MRI对冈上肌腱、冈下肌腱、肩胛下肌腱的检出率显著低于关节镜检查(P<0.05);136例肩袖损伤患者中全层撕裂45例,部分撕裂91例,MRI诊断全层撕裂准确率为93.33%(42/45),部分撕裂为94.51%(86/91),总准确率为94.12%(128/136),显著低于关节镜检查(P<0.05);MRI测量全层撕裂肌腱断端回缩度、撕裂跨度的准确率分别为86.67%(39/45)、82.22%(37/45)。结论:MRI对肩袖损伤及肌腱撕裂程度均具有较高的诊断价值,可为肩袖损伤提供可靠的术前诊断依据,值得在临床推广应用。 展开更多
关键词 肩袖损伤 核磁共振成像 肩袖撕裂 肌腱
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关节镜下“Chinese way”治疗老年肩关节脱位合并巨大肩袖撕裂的临床疗效 被引量:1
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作者 孙晟轩 谢晔 +1 位作者 沈光思 周海斌 《中国临床解剖学杂志》 CSCD 北大核心 2024年第3期316-321,共6页
目的 评估“Chinese way”技术行上关节囊重建在关节镜下治疗老年肩关节脱位合并巨大肩袖撕裂的临床效果。方法 回顾性分析2019年5月至2022年1月在苏州大学附属第二医院收治的老年肩关节脱位后合并巨大肩袖撕裂的患者资料,纳入36例,男16... 目的 评估“Chinese way”技术行上关节囊重建在关节镜下治疗老年肩关节脱位合并巨大肩袖撕裂的临床效果。方法 回顾性分析2019年5月至2022年1月在苏州大学附属第二医院收治的老年肩关节脱位后合并巨大肩袖撕裂的患者资料,纳入36例,男16例,女20例,年龄52~73岁,平均(62.3±4.7)岁,术中行肱二头肌长头腱转位,加强肩袖缝合。统计分析术前、术后的疼痛、肩关节活动度及肩关节功能评分,通过MR评估肩袖再撕裂率。结果 所有患者均获得随访,随访时间为17.6±4.5个月。末次随访时肩关节前屈、外展、体侧外旋、体侧内旋活动度较术前均有显著增加(P<0.05);末次随访VAS评分、ASES评分、Constant-Murley评分、UCLA评分较术前均有明显改善(P<0.05);无肩关节再次脱位发生,MR依据Sugaya标准提示5例(13.9%)肩袖再撕裂,UCLA评分优9例,良23例,差4例,优良率为88.9%。结论 关节镜下处理老年肩关节脱位合并巨大肩袖损伤时,采用“Chinese way”技术重建上关节囊,加强缝合肩袖组织,可有效避免肩袖再撕裂,解除肩关节疼痛,恢复肩关节功能并防止再次脱位。 展开更多
关键词 关节镜 巨大肩袖损伤 肩关节脱位 修复外科手术
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肩袖损伤中不同保守治疗策略的应用现状及研究进展 被引量:1
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作者 李旭 李军 +3 位作者 郭孝菊 姚玲 林文华 徐永清 《生物骨科材料与临床研究》 CAS 2024年第4期87-90,93,共5页
肩袖(rotator cuff, RC)损伤是指组成肩袖的冈上肌、冈下肌、肩胛下肌和小圆肌的损伤。目前对肩袖损伤的保守治疗方式缺乏统一性,本文通过搜索国内外关于肩袖损伤保守治疗相关文献,学习和研究不同保守治疗方式及不同类型富含血小板血浆... 肩袖(rotator cuff, RC)损伤是指组成肩袖的冈上肌、冈下肌、肩胛下肌和小圆肌的损伤。目前对肩袖损伤的保守治疗方式缺乏统一性,本文通过搜索国内外关于肩袖损伤保守治疗相关文献,学习和研究不同保守治疗方式及不同类型富含血小板血浆的应用现状,为临床治疗肩袖损伤提供最优治疗方法,为未来肩袖损伤的治疗及研究方向提供思路。目前,用于肩袖损伤的保守治疗方式有富血小板血浆注射治疗、干细胞治疗、皮质类固醇注射和口服非甾体抗炎药物治疗、物理治疗等。其中多次、大剂量、超声引导下注射未激活贫白细胞富血小板血浆(leukocyte-poor platelet-rich plasma, P-PRP)在肩袖损伤的保守治疗效果中可能更占优势,但是在选择治疗方案时需与患者的经济条件相结合。未来或许可以围绕多种治疗方式联合使用治疗肩袖损伤。 展开更多
关键词 生物材料 富血小板血浆 干细胞 肩袖损伤 骨科
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肩袖损伤患者术后康复锻炼依从性的影响因素 被引量:1
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作者 王凯 胡滨 《中国民康医学》 2024年第8期1-4,共4页
目的:分析肩袖损伤患者术后康复锻炼依从性的影响因素。方法:选取2021年5月至2023年5月该院收治的126例肩袖损伤患者进行横断面研究,统计肩袖损伤患者术后康复锻炼依从性情况,采用Logistic回归分析肩袖损伤患者术后康复锻炼依从性的影... 目的:分析肩袖损伤患者术后康复锻炼依从性的影响因素。方法:选取2021年5月至2023年5月该院收治的126例肩袖损伤患者进行横断面研究,统计肩袖损伤患者术后康复锻炼依从性情况,采用Logistic回归分析肩袖损伤患者术后康复锻炼依从性的影响因素。结果:126例肩袖损伤患者中完全依从28例,部分依从56例,依从性为66.67%(84/126),设为依从组;不依从42例,设为不依从组;不依从组年龄≥60岁、合并慢性病种类≥2种、无康复人员帮助、自觉康复锻炼动作难度较大、无家属经常鼓励等占比均高于依从组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,年龄≥60岁、合并慢性病种类≥2种、无康复人员帮助、自觉康复锻炼动作难度较大、无家属鼓励等均为影响肩袖损伤患者术后康复锻炼依从性的危险因素(OR>1,P<0.05)。结论:年龄≥60岁、合并慢性病种类≥2种、无康复人员帮助、自觉康复锻炼动作难度较大、无家属鼓励等均为影响肩袖损伤患者术后康复锻炼依从性的危险因素。 展开更多
关键词 肩袖损伤 康复锻炼 依从性 影响因素
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关节镜下肩袖缝线桥缝合术后疼痛的原因分析
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作者 司丽娜 罗金伟 +3 位作者 吴迪 乔跃兵 吕永明 徐丛 《解剖学报》 CAS CSCD 2024年第2期210-214,共5页
目的探讨关节镜下肩袖缝线桥缝合术后患者疼痛的相关因素。方法收集112例接受关节镜下缝线桥缝合的单侧肩袖损伤患者资料,以电话随访的形式,通过数字评分法(NRS)调查患者术后3个月时疼痛情况;SPSS 23.0统计学软件录入数据并分析,采用单... 目的探讨关节镜下肩袖缝线桥缝合术后患者疼痛的相关因素。方法收集112例接受关节镜下缝线桥缝合的单侧肩袖损伤患者资料,以电话随访的形式,通过数字评分法(NRS)调查患者术后3个月时疼痛情况;SPSS 23.0统计学软件录入数据并分析,采用单因素分析及多重线性回归分析,评价上述影响因素与术后疼痛的相关性。结果单因素分析结果显示,病程、吸烟史、患者术前美国加利福尼亚大学洛杉矶分校(UCLA)评分、Constant评分、NRS、肩袖撕裂大小、是否为全层撕裂和肌腱回缩程度8个因素可能与术后疼痛有关(P<0.05)。而患者的年龄、性别、身体质量指数(BMI)、饮酒史、是否合并糖尿病及高血压则与术后疼痛无关(P>0.05)。多重线性回归分析表明,与术后疼痛相关的因素有4个,其相关程度依次是术前NRS、术前UCLA评分、撕裂大小和吸烟史。结论影响关节镜下肩袖缝线桥缝合术术后疼痛的复杂且多样,进行术后疼痛的原因分析,可有效减轻患者术后的疼痛,有助于促进肩着节功能恢复。 展开更多
关键词 肩袖损伤 术后疼痛 关节镜 数字评分法
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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 被引量:1
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作者 张阿勤 《中国医药指南》 2024年第10期37-40,共4页
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... 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。 展开更多
关键词 肩袖损伤 关节镜手术 针对性康复护理 肩关节功能 护理满意度
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