关节镜全镜下缝合修复肩袖损伤16例临床分析

【目的】探讨关节镜全镜下缝合修复肩袖损伤的适应证选择、手术技巧和临床疗效。【方法】自2012年1月至2013年12月收治16例肩袖损伤患者，采用关节镜全镜下肩袖重建修复肩袖损伤，分别在术前及术后末次随访时采用美国肩肘医师协会评分（ASES）、Constant-Murley评分以及简易肩关节评分（SST）问卷进行功能恢复评估。【结果】本组16例均获得随访，随访时间3～21个月，平均12个月。16例患者，ASES评分：平均术前72．3分，而术后87．1分；SST评分：术前6．1分，而术后10．7分；肩关节活动度：平均前屈上举为术前150．3°，而术后173．3°，平均外旋为术前28．5°，而术后45．2°；Constant-M urley评分：平均术前70．9分，而术后85．4分。上述各指标手术后均较术前明显改善，其差异均有统计学意义（均 P ＜0．05）。【结论】肩关节镜全镜下肩袖重建手术具有损伤小、肩关节功能恢复快等特点，是治疗肩袖损伤的有效方法之一。正确的适应证选择、熟练的关节镜下操作技术以及术后严格的功能康复锻炼是手术成功的关键。

Clinical Analysis of Arthroscopic Suture for Repairing 16 Patients with Rotator Cuff Injury

Objective] To explore the indications ,surgical skills and clinical efficacy of arthroscopic su-ture for repairing rotator cuff injury .Methods] Totally 16 patients with rotator cuff injury from Jan .2012 to Dec .2013 underwent arthroscopic reconstruction of rotator cuff .American shoulder and elbow physician asso-ciation score（ASES） ,Constant-Murley score and simple shoulder test （SST ） questionnaires before operation and in the last follow up after operation were used to assess the functional recovery .Results]All the 16 pa-tients were followed up for 3-21 months（average 12 months） .Mean ASES scores before and after operation were 72 .3 and 87 .1 ,respectively .SST scores before and after operation were 6 .1 and 10 .7 ,respectively . Mean forward flexion and elevation before and after treatment were 150 .3° and 173 .3° ,respectively .Mean ex-ternal rotation before and after operation were 28 .5° and 45 .2° ,respectively .Mean Constant-Murley scores before and after operation were 70 .9 and 85 .4 ,respectively .Compared with before operation ,the above inde-xes after operation were improved obviously ,and there were significant differences （all P 〈0 .05） .Conclu-sion]Arthroscopic reconstruction of rotator cuff has advantages such as minimal injury and quick recovery of shoulder joint function ,so it is an effective method for the treatment of rotator cuff injury .Correct indication choice ,perfect arthroscopic operation skills and strict functional rehabilitation are the key for the successful operation .