全关节镜下肩袖修补术对老年肩袖损伤患者术后72 h内疼痛程度和并发症的影响

目的:分析全关节镜下肩袖修补术与小切口肩袖修补术对老年肩袖损伤患者的临床效果。方法:选取2017年1月至2018年11月收治的60例老年肩袖损伤患者作为研究对象,男37例,女23例;年龄61~77(63.45±12.34)岁;病程6~12(5.32±1.02)个月;左侧29例,右侧31例。其中,行全关节镜下肩袖修补术者30例,为观察组;行小切口肩袖修补术者30例,为对照组。观察并记录两组患者术前术后美国加州大学肩关节评分系统(University of California,Los Angeles,UCLA)评分,美国肩肘外科协会(American Shoulder and Elbow Surgeons,ASES)评分,Constant-Murley评分,肩关节前屈活动度、外旋活动度、外展活动度,术后72 h内视觉模拟疼痛评分(visual analogue scale,VAS)及并发症发生情况,然后进行对比分析。结果:两组患者术后UCLA评分、ASES评分、Constant-Murley评分较术前均显著提高(P<0.05),两组术后UCLA、ASES、Constant-Murley评分相比差异无统计学意义(P>0.05)。两组患者术后肩关节前屈活动度、外旋活动度、外展活动度较术前均显著增加(P<0.05),术后两组间比较差异无统计学意义(P>0.05);观察组术后24、48、72 h VAS低于对照组(P<0.05);观察组并发症总发生率13.33%(4/30)低于对照组33.33%(10/30)(P<0.05)。结论:全关节镜下肩袖修补术和小切口肩袖修补术均可以改善老年肩袖损伤后的肩部功能,但全关节镜下肩袖修补术后72 h内疼痛程度和并发症均明显优于小切口肩袖修补术,可根据患者临床实际情况与需求进行选择。

Effect of total arthroscopic rotator cuff repair on pain degree and complications of elderly patients with rotator cuff injury within 72 hours after operation

Objective: To analyze the clinical effect of rotator cuff repair and small incision rotator cuff repair under the total arthroscopy in elderly patients with rotator cuff injury. Methods: A total of 60 elderly patients with rotator cuff injury from January 2017 to November 2018 were selected as the research objects,including 37 males and 23 females;aged from 61 to 77 years old with an average of (63.45±12.34) years old;disease duration ranged from 6 to 12 months,with an average of (5.32±1.02) months;29 cases on the left side and 31 cases on the right side. Among them,30 patients underwent total arthroscopic rotator cuff repair (observation group),30 patients underwent small-incision rotator cuff repair(control group). The scores of University of California,Los Angeles(UCLA) shoulder rating scale,before and after surgery in the two groups were observed and recorded. The American Shoulder and Elbow Surgeons(ASES) score,Constant-Murley score,shoulder flexion range of motion,external rotation range of motion,abduction range of motion,visual analogue scale(VAS) within 72 hours after surgery,as well as the complcations were compared. Results: The postoperative UCLA score,ASES score and Constant-Murley score between two groups were significantly higher than those before operation (P<0.05). There was no significant difference in postoperative UCLA,ASES and Constant-Murley score between two groups (P>0.05). The shoulder flexion range of motion,external rotation range of motion and abduction range of motion between two groups were significantly higher than those before operation (P<0.05). There was no significant difference between the two groups after operation (P>0.05). The VAS at 24,48 and 72 h after operation in observation group were significantly lower than those in control group (P<0.05). The total incidence of complications in observation group(13.33%,4/30) was sinificantly lower(P<0.05)than that in control group(33.33%,10/30). Conclusion: Total arthroscopic rotator cuff repair and small incision rotator cuff repair can improve the shoulder function after rotator cuff injury in elderly,but the degree of pain and complications within 72 hours after total arthroscopic rotator cuff repair are significantly better than small incision rotator cuff repair,which can be selected according to the clinical situation and needs of patients.