| 谭 宇,张 俊,王 力,张年春,刘昆仑.关节镜下双排缝合桥固定与单排固定治疗肩袖全层撕裂的疗效对比及术后早期再撕裂的危险因素分析[J].,2023,(17):3321-3325 |
| 关节镜下双排缝合桥固定与单排固定治疗肩袖全层撕裂的疗效对比及术后早期再撕裂的危险因素分析 |
| Comparison of the Efficacy of Double-Row Suture Bridge Fixation and Single Row Fixation Under Arthroscope in the Treatment of Full-Thickness Rotator Cuff Tear and Analysis of the Risk Factors of Early Postoperative Retear |
| 投稿时间：2023-02-25 修订日期：2023-03-21 |
| DOI：10.13241/j.cnki.pmb.2023.17.023 |
| 中文关键词: 关节镜 双排缝合桥固定 单排固定 肩袖 撕裂 疗效 术后早期 危险因素 |
| 英文关键词: Arthroscope Double-row suture bridge fixation Single row fixation Rotator cuff Tear Efficacy Early postoperative Risk factors |
| 基金项目:重庆市自然科学基金项目（cstc2018jcyjA0516）；重庆市渝中区科委课题（20210147） |
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| 中文摘要: |
| 摘要 目的：对比关节镜下双排缝合桥固定和单排固定治疗肩袖全层撕裂的疗效，并分析术后早期再撕裂的危险因素。方法：回顾性分析广州中医药大学附属北碚中医院2018年1月~2021年12月期间收治的200例肩袖全层撕裂患者的临床资料，根据手术方案的不同分为A组（n=97，接受单排固定治疗）和B组（n=103，接受双排缝合桥固定治疗）。对比两组的疼痛、肩关节功能情况、肩关节活动度及术后早期再撕裂发生率。采用单因素和多因素Logistic回归分析肩袖全层撕裂患者术后早期再撕裂的危险因素。结果：术后6个月，B组视觉疼痛模拟评分量表（VAS）评分低于A组，美国加州大学肩关节评分系统（UCLA）评分、美国肩肘外科医师学会（ASES）评分高于A组（P<0.05）。术后6个月，B组前屈、外展、体侧外旋角度大于A组（P<0.05）。B组的术后早期再撕裂总发生率低于A组（P<0.05）。术后早期再撕裂的发生与糖尿病史、撕裂大小、吸烟史、年龄、术前肌肉质量、性别、脂肪浸润、注射皮质类固醇有关（P<0.05）。多因素Logistic回归分析结果显示：年龄≥60岁、性别为男性、吸烟史、糖尿病史、撕裂大小为巨大型再撕裂、脂肪浸润、注射皮质类固醇是术后早期再撕裂发生的危险因素（P<0.05）。结论：关节镜下双排缝合桥固定治疗肩袖全层撕裂，可更好的减轻疼痛症状，改善关节功能和关节活动度。此外，糖尿病史、脂肪浸润、吸烟史、高龄、撕裂大小为巨大型再撕裂、男性、注射皮质类固醇等是肩袖全层撕裂患者术后早期再撕裂的危险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To compare the efficacy of double-row suture bridge fixation and single row fixation under arthroscope in the treatment of full-thickness rotator cuff tear, and to analyze the risk factors of early postoperative retear. Methods: Clinical data of 200 patients with full-thickness rotator cuff tear who were admitted to Beibei Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Traditional Chinese Medicine from January 2018 to December 2021 were retrospectively analyzed, and they were divided into group A (n=97, receiving single row fixation) and group B (n=103, receiving double-row suture bridge fixation) according to different surgical programs. Pain, shoulder function, shoulder joint range of motion and the incidence of early postoperative retear were compared in the two groups. Univariate and multivariate Logistic regression were used to analyze the risk factors of early postoperative retear in patients with full-thickness rotator cuff tear. Results: 6 months after operation, the visual pain simulation scale (VAS) score in the group B was lower than that in the group A, while the University of California at Los Angeles (UCLA) score and American shoulder and elbow surgeons (ASES) score were higher than those in the group A (P<0.05). 6 months after operation, the angles of anteflexion, abduction and lateral external rotation in the group B were greater than those in the group A(P<0.05). The total incidence of early postoperative retear in the group B was lower than that in the group A(P<0.05). Early postoperative retear was related to the diabetes history, tear size, smoking history, age, preoperative muscle mass, gender, fat infiltration and corticosteroid injection (P<0.05). Multivariate Logistic regression analysis showed that age≥60 years, gender with male, smoking history, diabetes history, tear size of giant type retear, fat infiltration, and corticosteroid injection were the risk factors for occurrence of early postoperative retear (P<0.05). Conclusion: The double-row suture bridge fixation under arthroscope in the treatment of full-thickness rotator cuff tear can better relieve pain symptoms, improve joint function and range of motion. In addition, diabetes history, adipose infiltration, smoking history, advanced age, tear size of giant type retear, male, corticosteroid injection are risk factors for early postoperative retear in patients with full-thickness rotator cuff tear. |
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