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-  2017 

关节镜下缝线桥分层修复术治疗肩袖分层撕裂的临床研究

DOI: doi:10.7507/1002-1892.201703005

Keywords: 肩袖分层撕裂, 缝线桥, 分层修复, 全层修复

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Abstract:

目的 评价关节镜下缝线桥分层修复术治疗肩袖分层撕裂的临床疗效。 方法 将2013 年 5 月—2015 年 5 月符合选择标准的 54 例肩袖分层撕裂患者纳入研究,随机分为两组,试验组 28 例行关节镜下缝线桥分层缝合修复,对照组 26 例行关节镜下缝线桥全层缝合修复。两组患者性别、年龄、侧别、撕裂类型以及术前疼痛视觉模拟评分(VAS)、肩关节 Constant 评分、美国肩肘外科协会评分(ASES)、美国加州大学洛杉矶分校(UCLA)评分、肩关节前屈活动度、体侧外旋活动度比较,差异均无统计学意义(P>0.05)。术后随访并比较两组肩关节功能评分、活动度及肩袖再撕裂发生情况。 结果 试验组手术时间较对照组延长,比较差异有统计学意义(t=8.383,P=0.000)。术后两组切口均 Ⅰ 期愈合,无手术相关并发症发生。患者均获随访 12 个月,两组术后 12 个月时 UCLA、ASES、VAS、Constant 评分及肩关节前屈、外旋活动度与术前比较,差异均有统计学意义(P<0.05);两组间以上指标比较,差异均无统计学意义(P>0.05)。术后 12 个月,试验组 4 例(14.3%)、对照组 5 例(19.2%)患者发生肩袖再撕裂,发生率比较差异无统计学意义(χ2=0.237,P=0.626)。 结论 关节镜下缝线桥分层修复术治疗肩袖分层撕裂,在肩关节功能评分、肩关节活动度及术后再撕裂方面与传统缝线桥全层固定术比较无明显差异,而且手术时间较长

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