关节镜下手术治疗老年肩袖损伤的临床效果

摘要
图/表
参考文献(22)
相关文章 (15)

全文: PDF (598 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨65岁以上肩袖损伤患者关节镜下手术治疗与保守治疗的效果差别。方法选取2011年5月~2014年6月在承德医学院附属医院关节外科进行肩袖损伤治疗患者50例，依据患者治疗意愿进行分组，采用全关节镜或肩关节镜辅助小切口治疗的肩袖撕裂患者30例为手术组，采用保守治疗的肩袖撕裂患者20例为保守组。比较两组患者治疗前与末次随访时疼痛视觉模拟评分（VAS）、美国加州大学肩关节评分系统（UCLA）及肩肘外科医师评分（ASES），评价术后肩关节功能恢复情况。结果所有患者术后获得24~36个月的随访。术后无感染、切口不愈合、二次断裂等并发症发生。手术组和保守组患者治疗前肩关节功能评分比较，差异无统计学意义（P > 0.05）；两组患者肩关节功能末次随访时较治疗前明显改善，差异有统计学意义（P < 0.05），且手术治疗组优于保守治疗组，差异有统计学意义（P < 0.05）。结论关节镜下治疗65岁以上老年肩袖损伤术后疼痛缓解满意，肩关节功能恢复明显。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	戴海峰1 李嘉1 王智慧1 刘凤2 徐丛1▲

关键词 ：肩袖, 老年人, 关节镜, 疗效

Abstract：Objective To investigate the difference of curative effect between arthroscopic surgery and conservative treatment for rotator cuff injury in patients over 65 years. Methods From May 2011 to June 2014, in Department of Joint Surgery, Affiliated Hospital of Chengde Medical College, 50 patients with rotator cuff injuries were selected, the patients were divided into two groups according to patients' treatment willingness, 30 cases treated with arthroscopy or shoulder arthroscopy were selected as operation group, and 20 cases treated conservative method were selected as conservation group. The pain visual analogue scale (VAS), American shoulder and elbow surgeons (ASES) and shoulder joint score system in California University (UCLA) were compared, and the recovery of shoulder function after surgery were also evaluated. Results All patients were followed up for 24-36 months. No complication such as infection, incision not healing, secondary crack were observed. There was no significant difference in shoulder function scores between the operation group and the conservation group before treatment (P > 0.05); the shoulder joint function in two groups at the last follow-up significantly improved compared with before treatment, and this in operation group was bwtter than that in conservation group, the difference were statistically significant (P < 0.05). Conclusion Arthroscopic surgery to repair rotator cuff injuries in patients over the age of 65 years can improve function and pain relief.

Key words： Rotator cuff Aged Arthroscopic Effective

基金资助:河北省医学科学研究重点课题计划（20170233）。

通讯作者: ▲通讯作者

引用本文:

戴海峰1 李嘉1 王智慧1 刘凤2 徐丛1▲. 关节镜下手术治疗老年肩袖损伤的临床效果[J]. 中国医药导报, 2017, 14(27): 89-92.
DAI Haifeng1 LI Jia1 WANG Zhihui1 LIU Feng2 XU Cong1▲. Clinical effect of arthroscopic surgery for rotator cuff injuries in the elderly. 中国医药导报, 2017, 14(27): 89-92.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2017/V14/I27/89

[1] Lin JC，Weintraub N，Aragaki DR. Nonsurgical treatment for rotator cuff injury in the elderly [J]. Am Med DAssoc，2008，9（9）：626-632.
[2] Heather M，David J.Clinical applications of visual analogue scales：a critical review[J].Psychol Med，1988，18（4）：1007-1019.
[3] Russell D，Letitia A，Carolyn E. The revised UCLA Loneliness Scale：Concurrent and discriminant validity evidence [J]. J Pers Soc Psychol，1980，39（3）：472-480.
[4] Minagawa H，Yamamoto N，Abe H，et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population：From mass-screening in one village [J]. J Orthop，2013，10（1）：8-12.
[5] Yamamoto A，Takagishi K，Osawa T，et al. Prevalence and risk factors of a rotator cuff tear in the general population [J]. J Shoulder Elbow Surg，2010，19（1）：116-120.
[6] 张磊，马佳，刘劲松，等.老年人肩袖损伤特点及关节镜手术中期疗效[J].中国微创外科杂志，2016，16（6），525-528.
[7] Gumina S，Carbone S，Campagna V，et al. The impact of aging on rotator cuff tear size [J]. Musculoskelet Surg，2013， 97（1）：69-72.
[8] Melis B，Nemoz C，Walch G. Muscle fattty infiltration in rotator cuff tears：de scriptive analysis of 1688 cases [J]. Orthop Traumatol Surg Res，2009，95（5）：319-324.
[9] Yamaguchi K，Tetro AM，Blam O，et al. Natural history of asymptomatic rotator cuff tears：a longitudinal analysis of asymptomatic tears detected sonographically [J]. J Shoulder Elbow Surg，2001，10（3）：199-203.
[10] 李小飞，谢文瑾，盛路新.老年退变性肩袖损伤的肩关节镜治疗[J].实用骨科杂志，2016，22（2）：107-110.
[11] Rebuzzi E，Coletti N，Schiavetti S，et al. Arthroscopic rotator cuff repair in patients older than 60 years [J]. Arthro?scopy，2005，21（1）：48-54.
[12] Kukkonen J，Joukainen A，Lehtinen J，et al. Treatment of nontraumatic rotator cuff tears：A randomised controlled trial with one-year clinical results [J]. Bone Joint J，2014， 96（B）：75-81.
[13] Gialanella B，Bertolinelli M. Corticosteroids injection in rotator cuff tears in elderly patient：pain outcome prediction [J]. Geriatr Gerontol Int，2013，13（4）：993-1001.
[14] Lambers Heerspink FO，van Raay JJ，Koorevaar RC，et al. Comparing surgical repair with conservative treatment for degenerative rotator cuff tears：a randomized controlled trial [J]. J Shoulder Elbow Surg，2015，24（8）：1274-1281.
[15] Flurin PH，Hardy P，Abadie P，et al. Rotator cuff tears after 70 years of age：a prospective，randomized，comparative study between decompression and arthroscopic repair in 154 patients [J]. Orthop Traumatol Surg Res，2013， 99（8 Suppl）：S371-S378.
[16] Park JG，Cho NS1，Song JH，et al. Rotator Cuff Repair in Patients over 75 Years of Age：Clinical Outcome and Repair Integrity [J]. Clin Orthop Surg，2016，8（4）：420-427.
[17] Parnes N，DeFranco M，Wells JH，et al. Complications after arthroscopic revision rotator cuff repair [J]. Arthroscopy，2013，29（9）：1479-1486.
[18] Verma NN，Bhatia S，Baker CL，et al. Outcomes of arthroscopic rotator cuff repair in patients aged 70 years or older [J]. Arthroscopy，2010，26（10）：1273-1280.
[19] 陈刚，潘界恩.关节镜下双排缝合桥技术治疗中大型肩袖全层撕裂[J].中华创伤杂志，2015，31（9）：923-927.
[20] 邓威，谌业帅，郑欣，等.关节镜下双排缝合桥固定技术修复大型肩袖撕裂的临床观察[J].中华骨与关节外科杂志，2017，10（1）：48-50.
[21] 孙超，潘昭勋，杨晓明，等.关节镜下反向肩峰减压术在肩袖撕裂治疗中的应用[J].中国修复重建外科杂志，2016， 30（8）：943-946.
[22] 陆兮，刘玉杰，曲峰，等.肱二头肌长头腱与冈上肌腱联合修复巨大肩袖损伤的疗效分析[J].中国矫形外科杂志，2016，24（20）：1825-1830.