[1]凡有非,夏 胜,尤 琳,等.关节镜下双排缝线桥技术治疗大型肩袖撕裂疗效观察[J].新乡医学院学报,2021,38(4):365-369.[doi:10.7683/xxyxyxb.2021.04.015]
 FAN Youfei,XIA Sheng,YOU Lin,et al.Effect of arthroscopic double-row suture bridge technique in the treatment of large rotator cuff tears[J].Journal of Xinxiang Medical University,2021,38(4):365-369.[doi:10.7683/xxyxyxb.2021.04.015]
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关节镜下双排缝线桥技术治疗大型肩袖撕裂疗效观察
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
38
期数:
2021年4
页码:
365-369
栏目:
临床研究
出版日期:
2021-04-05

文章信息/Info

Title:
Effect of arthroscopic double-row suture bridge technique in the treatment of large rotator cuff tears
作者:
凡有非夏 胜尤 琳陈先帅李久源刘 舰赵 超
(亳州市人民医院骨科,安徽 亳州 236800)
Author(s):
FAN YoufeiXIA ShengYOU LinCHEN XianshuaiLI JiuyuanLIU JianZHAO Chao
(Department of Osteology,the People′s Hospital of Bozhou,Bozhou 236800,Anhui Province,China)
关键词:
大型肩袖撕裂双排缝线桥技术肩关节功能
Keywords:
large rotator cuff teardouble-row suture bridge technologyshoulder joint function
分类号:
R615
DOI:
10.7683/xxyxyxb.2021.04.015
文献标志码:
A
摘要:
目的 探讨关节镜下双排缝线桥技术治疗大型肩袖撕裂的临床效果。方法 选择2018年6月至2019年6月亳州市人民医院收治的40例大型肩袖撕裂患者为研究对象,所有患者行关节镜下肩袖修复术,根据手术方式将患者分成观察组(n=21)和对照组(n=19),对照组患者采用单排锚钉缝合固定术,观察组患者采用双排缝线桥技术。术后3、12个月应用加利福尼亚大学洛杉矶分校(UCLA)评分系统评估患者的肩关节恢复效果;术前及术后3、6、12个月,应用美国肩肘外科协会(ASES)评分系统评估患者的肩关节功能,采用视觉模拟评分法(VAS)评估患者肩关节疼痛程度;术后3、6、12个月应用持续性被动活动度测量装置测定患者肩关节外展上举活动度;术后12个月患者复查肩关节磁共振成像,评估肩袖再撕裂情况;并观察2组患者并发症发生情况。结果 观察组患者术后3、12个月肩关节恢复优良率分别为76.19%(16/21)、95.24%(20/21),对照组患者术后3、12个月肩关节恢复优良率均为63.16%(12/19);2组患者术后3个月肩关节恢复优良率比较差异无统计学意义(χ2=0.807,P>0.05),术后12个月观察组患者肩关节恢复优良率显著高于对照组(χ2=4.568,P<0.05)。2组患者术前ASES、VAS评分比较差异无统计学意义(P>0.05);与术前比较,2组患者术后3、6、12个月ASES评分显著升高,VAS评分显著降低(P<0.05);与术后3个月比较,2组患者术后6、12个月ASES评分显著升高,VAS评分显著降低(P<0.05);与术后6个月比较,2组患者术后12个月ASES评分显著升高,VAS评分显著降低(P<0.05)。术后3、6、12个月,观察组患者ASES评分显著高于对照组(P<0.05);术后3个月,观察组患者VAS评分显著低于对照组(P<0.05);2组患者术后6、12个月VAS评分比较差异无统计学意义(P>0.05)。2组患者术前肩关节外展上举活动度比较差异无统计学意义(P>0.05);2组患者术后3、6、12个月肩关节外展上举活动度显著大于术前(P<0.05),2组患者术后6、12个月肩关节外展上举活动度显著大于术后3个月(P<0.05),2组患者术后12个月肩关节外展上举活动度显著大于术后6个月(P<0.05);2组患者术后3、6、12个月肩关节外展上举活动度比较差异无统计学意义(P>0.05)。术后12个月,观察组和对照组患者肩袖再撕裂发生率分别为0.00%(0/21)、26.32%(5/19),观察组患者肩袖再撕裂发生率显著低于对照组(χ2=4.139,P<0.05)。观察组和对照组患者并发症发生率分别为9.52%(2/21)、15.79%(3/19),2组患者并发症发生率比较差异无统计学意义(χ2=0.014,P>0.05)。结论 与单排锚钉固定术相比,关节镜下双排缝线桥技术可以显著改善大型肩袖撕裂患者的肩关节功能,减轻患者疼痛,降低肩袖再撕裂发生率。
Abstract:
Objective To investigate the clinical effect of arthroscopic double-row suture bridge technique in the treatment of large rotator cuff tears.Methods  Forty patients with large rotator cuff tears admitted to the People′s Hospital of Bozhou from June 2018 to June 2019 were selected as the research subjects.All patients underwent arthroscopic rotator cuff repair,and the patients were divided into observation group (n=21) and control group (n=19) according to the operation methods.The patients in the control group were treated with single-row anchor suture fixation,while the patients in the observation group were treated with double-row suture bridge technology.The recovery effect of the shoulder joint was evaluated by the University of California Los Angeles (UCLA) scoring system at 3 and 12 months after operation.Before operation and 3,6,12 months after operation,the shoulder joint function was assessed by the American Shoulder and Elbow Surgeons (ASES) scoring system,and the shoulder pain was evaluated by the visual analogue scales (VAS).The abduction and superduct range of shoulder joint were measured with the continuous passive motion measurement device at 3,6 and 12 months after operation.The patients were reexamined with magnetic resonance imaging at 12 months after operation to evaluate the re-tearing of rotator cuff.The complications of the patients in the two groups were observed.Results The fineness rate of shoulder joint recovery at 3 and 12 months after operation in the observation group was 76.19% (16/21) and 95.24% (20/21),respectively.The fineness rate of shoulder joint recovery at 3 and 12 months after operation in the control group was all of 63.16% (12/19).There was no significant difference in the fineness rate of shoulder joint recovery between the two groups at 3 months after operation (χ2=0.807,P>0.05).The fineness rate of shoulder joint recovery in the observation group was significantly higher than that in the control group at 12 months after operation (χ2=4.568,P<0.05).There was no significant difference in the ASES and VAS scores between the two groups before operation (P>0.05).Compared with preoperation,the ASES score was significantly higher and the VAS score was significantly lower in the two groups at 3,6 and 12 months after operation (P<0.05).Compared with 3 months after operation,the ASES score was significantly higher and the VAS score was significantly lower in the two groups at 6 and 12 months after operation (P<0.05).Compared with 6 months after operation,the ASES score was significantly higher and the VAS score was significantly lower in the two groups at 12 months after operation (P<0.05).The ASES score in the observation group was significantly higher than that in the control group at 3,6 and 12 months after operation (P<0.05).The VAS score in the observation group was significantly lower than that in the control group at 3 months after operation (P<0.05),but there was no significant difference in the VAS score between the two groups at 6 and 12 months after operation (P>0.05).There was no significant difference in shoulder abduction and superduct range between the two groups before operation (P>0.05).The shoulder abduction and superduct range at 3,6 and 12 months after operation was significantly greater than that before operation in the two groups (P<0.05).The shoulder abduction and superduct range at 6 and 12 months after operation was significantly greater than that at 3 months after operation in the two groups (P<0.05).The shoulder abduction and superduct range at 12 months after operation was significantly greater than that at 6 months after operation in the two groups (P<0.05).There was no significant difference in shoulder abduction and superduct range between the two groups at 3,6 and 12 months after operation (P>0.05).Within 12 months after operation,the incidence of rotator cuff re-tearing in the observation group and the control group was 0.00% (0/21) and 26.32% (5/19),respectively.The incidence of rotator cuff re-tearing in the observation group was significantly lower than that in the control group (χ2=4.139,P<0.05).The incidence of complications in the observation group and the control group was 9.52% (2/21) and 15.79% (3/19),respectively.There was no significant difference in the incidence of complications between the two groups (χ2=0.014,P>0.05).Conclusion Compared with single-row anchor suture fixation,arthroscopic double-row suture bridge technique can significantly improve the shoulder function,reduce the pain of patients,and decrease the incidence of rotator cuff re-tearing in patients with large rotator cuff tear.

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更新日期/Last Update: 2021-04-05