体外冲击波对于肩袖修补术后患者功能恢复的疗效观察

目的:观察行肩关节镜下肩袖修补术的患者在术后康复训练的基础上配合使用体外冲击波治疗(ESWT)的临床效果。方法:此项研究选取肩袖损伤诊断明确且保守治疗无效的患者共计68例,随机分为观察组和对照组,每组34例。2组患者术后0~12周分3个阶段行制动康复训练、保护康复训练、增强康复训练。2组患者均采用被动功能训练,观察组同时增加体外冲击波辅助治疗。分别于患者术前、术后3周、6周及12周采用UCLASS评分、Constant评分、VAS评分和ROM评分评估患肩功能恢复情况。结果:术后3周、6周及12周,2组分别与组内术前比较,UCLASS、constant及ROM评分均有显著提高(P<0.05),VAS评分显著降低(P<0.05),术后3周、6周及12周,2组各评分行组间比较差异均有统计学意义(P<0.05)。结论:对于肩关节镜下行肩袖修补术的患者在术后康复训练的基础上早期提供规律的体外冲击波治疗能够显著改善患者的患侧肩关节功能恢复情况,另外在缓解疼痛方面疗效显著。

Effect of extracorporeal shock wave therapy on functional recovery after rotator cuff repair

Objective: To observe the clinical effect of extracorporeal shock wave therapy for patients undergoing postoperative rehabilitation training after arthroseopic rotator cuff repair. Methods: In this study 68 cases of rotator cuff injury were randomly divided into a treatment group and a control group, 34 cases in each group. According to the histology and biodynamics of rotator cuff healing and the patient''s condition, the rehabilitation training of braking was carried out during 0 6 weeks, protective rehabilitation training during 6 12 weeks, and enhanced rehabilitation training after 12 weeks. Both groups were treated with the above treatment regimen, and the treatment group was treated with the extracorporeal shock wave therapy additionally. Visual Analogue Scale (VAS), University of California at Los Angeles shoulder scores (UCLASS), Constant and Murley score (Constant), and range of motion (ROM) were assessed respectively preoperation, and 3, 6 and 12 weeks after operation to evaluate the recovery of shoulder function. Results: Intra group comparison of treatment group and control group at 3, 6 and 12 weeks after surgery showed that UCLASS, constant and ROM scores were significantly improved and VAS score was significantly reduced as compared with those before surgery (P<0.05). There were statistically significant differences between the two groups at 3, 6 and 12 weeks after surgery (P<0.05). Conclusion: The regular extracorporeal shock wave therapy can beused in patients undergoing arthroscopic rotator cuff repair and postoperative rehabilitation training early. This way can improve the recovery of shoulder joint function and relieve pain significantly.