[1]吴乐彬,孙风凡,童培建△.开放与关节镜下肌腱固定术治疗肱二头肌长头肌腱近端撕裂的临床研究[J].中国中医骨伤科杂志,2018,26(12):18-23.
　WU Lebin SUN Fengfan TONG Peijian.Which is Better for the Biceps Tendon Proximal Lesions: Open or Arthroscopic Biceps Tenodesis[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2018,26(12):18-23.
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开放与关节镜下肌腱固定术治疗肱二头肌长头肌腱近端撕裂的临床研究()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第26卷
期数:
2018年12期
页码:
18-23
栏目:
临床研究
出版日期:
2018-12-03

文章信息/Info

Title:
Which is Better for the Biceps Tendon Proximal Lesions: Open or Arthroscopic Biceps Tenodesis
文章编号:
1005-0205(2018)12-0018-06
作者:
吴乐彬1; 孙风凡2; 童培建3△
1浙江湖州市中医院(浙江 湖州,313000) 2浙江中医药大学 3浙江省中医院 △通信作者 E-mail:2382284276@qq.com
Author(s):
WU Lebin1 SUN Fengfan2 TONG Peijian3△
1Huzhou Hospital of Traditional Chinese Medicine, Huzhou 313000,Zhejiang China; 2Zhejiang University of Traditional Chinese Medicine, Hangzhou 310053, China; 3Zhejiang Hospital of Traditional Chinese Medicine, Hangzhou 310006, China.
关键词:
肱二头肌长头肌腱近端病损;  开放;  肩关节镜;  腱固定术
Keywords:
proximal lesions of biceps tendon;  open;  arthroscopy;  tenodesis
分类号:
R686.1
文献标志码:
A
摘要:
目的:通过回顾性研究对比传统开放与关节镜下肌腱固定术治疗肱二头肌长头肌腱近端撕裂临床疗效。方法:收集到符合纳入标准患者共38例,其中行切开腱固定术17例为切开组,行关节镜腱固定术21例为关节镜组。采用疼痛视觉模拟评分(VAS)、美国肩肘关节评分(ASES)及Costant-Murely肩关节功能评分对2组患者术前、术后多阶段肩关节功能疼痛评估; 术后末次随访采用患者满意度及Speed试验阳性来评估两组患者手术满意度和患肩残留痛。结果:组内比较:关节镜组与切开组患者术后各阶段评分均优于术前,差异性具有统计学意义; 评分随时间均呈改善趋势,但两组的改善趋势不完全一致。组间比较:在VAS评分中术后6个月和12个月组间差异无统计学意义(P>0.05),其余阶段前者低于后者,差异有统计学意义(P<0.05); Costant-Murley总分及前屈外展项目评分,在术后1和2个月两个阶段,前者高于后者,差异有统计学意义(P<0.05),其余阶段组间差异无统计学意义(P>0.05); 两组术后末次随访在满意度及Speed试验阳性(术后残留痛)总分比较差异无统计学意义(P>0.05)。结论:与切开腱固定技术相比,关节镜套扎缝合腱固定技术治疗LHBT近端撕裂除了更早更快改善患肩功能活动,缓解疼痛及恢复日常生活能力,且女性患者更愿意接受关节镜治疗。
Abstract:
Objective:To compare the clinical efficacy of traditional open and arthroscopic tenodesis in the treatment of proximal tear of biceps tendon by retrospective study.Methods: A total of 38 patients meeting the inclusion criteria were collected, among which 17 were treated with open tenodesis and 21 with arthroscopic tenodesis. Visual analogue scores(VAS), American shoulder elbow score(ASES)and Costant-Murely shoulder function scores were used to evaluate the function of the joints in the two groups before and after surgery. Patients' satisfaction and Speed test positivity were used to evaluate the surgical satisfaction and residual shoulder pain in the two groups during the last follow-up. Results: Intra-group comparison: postoperative scores of patients in the arthroscopy group and the incision group were better than those before surgery, and the differences were statistically significant. The scores showed an improvement trend over time, but the two groups did not show the same improvement trend. Comparison between groups: in the VAS score, there was no statistically significant difference between the two groups at 6 months and 12 months after surgery(P>0.05). In other stages, the former was lower than the latter(P<0.05).Costant-Murley total score and flexion-abduction score of the former were higher than those of the latter at 1 and 2 months after operation(P<0.05), and there was no significant difference in other stages(P>0.05).There was no significant difference in the total score of satisfaction and Speed test positivity(postoperative residual pain)in the last follow-up of the two groups(P>0.05).Conclusion: Compared with tendon incision tenodesis, the use of arthroscopic suture tenotomy for the treatment of LHBT proximal tears resulted in faster and earlier improvement of shoulder function and activity, pain relief and daily living ability. In addition, female patients were more likely to receive arthroscopic treatment.

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更新日期/Last Update: 2018-12-03