%0 Journal Article
%T 改良Weaver-Dunn术式与应用锁骨钩钢板或Endobutton钢板治疗肩锁关节脱位效果比较
%A 江涛　刘涛　叶发刚
%J -
%D 2020
%R 10.13362/j.jpmed.202002006
%X 摘要 目的　探讨改良Weaver-Dunn术式与应用锁骨钩钢板或Endobutton钢板治疗肩锁关节脱位的临床效果。 方法　回顾性分析我院2016年1月—2018年6月收治的109例Rockwood Ⅲ型肩锁关节脱位患者，患者根据治疗方案不同分为3组，A组（37例）采用改良Weaver-Dunn术式进行治疗，B组（35例）应用Endobutton钢板进行治疗，C组（37例）应用锁骨钩钢板进行治疗。分析3组患者手术时间、术中出血量、住院天数、并发症发生情况及末次随访时医疗费用等。均于术后3、6、12个月采用Constant-Murley评分评估患者肩关节功能，采用欧洲五维健康量表（EQ-5D）评估患者生活质量。 结果　3组患者均顺利完成手术，C组患者手术时间、术中出血量明显高于其他两组（F=50.27、63.40，q=30.35～80.27，P＜0.05），3组患者住院天数和并发症发生率比较差异均无显著性（P＞0.05）。术后3个月内3组患者Constant-Murley评分及EQ-5D指数比较差异无显著性（P＞0.05）；术后6、12个月A、B组患者Constant-Murley评分明显高于C组（F=3.39、3.22，q=79.19～87.74，P＜0.05），但3组患者EQ-5D指数比较差异均无显著性（P＞0.05）。末次随访时A、B、C组患者医疗费用比较差异有显著性（F=22.34,q=9.48～15.26，P＜0.05）。 结论　与锁骨钩钢板相比，改良Weaver-Dunn术式和Endobutton钢板治疗Rockwood Ⅲ型肩锁关节脱位的疗效更为满意，但改良Weaver-Dunn术式的总体医疗费用较低，可能是更为经济实用的治疗方案，值得临床推广应用。<br>Abstract：Objective　To investigate the clinical effect of the modified Weaver-Dunn surgical procedure versus clavicular hook plate or Endobutton plate in the treatment of acromioclavicular joint dislocation. Methods　A retrospective analysis was performed for 109 patients with Rockwood Ⅲ acromioclavicular joint dislocation who were admitted to our hospital from January 2016 to June 2018, and according to their treatment regimen, they were divided into group A (37 patients treated with the modified Weaver-Dunn surgical procedure), group B (35 patients treated with Endobutton plate), and group C (37 patients treated with clavicular hook plate). The three groups were compared in terms of time of operation, intraoperative blood loss, length of hospital stay, complications, and medical costs at the final follow-up. At 3,6, and 12 months after surgery, the Constant-Murley scale was used to evaluate shoulder joint function, and European Quality of Life-5 Dimensions (EQ-5D) was used to evaluate quality of life. Results　All the patients completed surgery successfully, and group C had significantly longer time of operation and significantly higher intraoperative blood loss than the other two groups (F=50.27,63.40,q=30.35-80.27,P<0.05), while there were no significant differences in length of hospital stay and incidence rate of complications between the three groups (P>0.05). There were no significant differences in Constant-Murley score and EQ-5D index between the three groups within 3 months after surgery (P>0.05); at 6 and 12 months after surgery, groups A and B had a significantly higher Constant-Murley score than group C (F=3.39,3.22,q=79.19-87.74,P<0.05), while there was no significant difference in EQ-5D index between the three groups (P>0.05). There was a significant difference in medical costs between groups A, B, and C at
%K 肩锁关节
%K 关节脱位
%K 内固定器
%K 改良Weaver-Dunn术式
%K 锁骨钩钢板
%K Endobutton钢板
%K 治疗结果<br>Acromioclavicular joint
%K Joint dislocations
%K Internal fixators
%K Modified Weaver-Dunn procedure
%K Clavicular hook plate
%K Endobutton plate
%K Treatment outcome
%U http://jpmed.qdu.edu.cn/CN/10.13362/j.jpmed.202002006