硬膜外穿刺针反向穿线过线法在肩袖损伤关节镜治疗中的应用

目的观察硬膜外穿刺针反向穿线过线法在肩袖损伤关节镜治疗中的应用效果，并与缝合枪过线法、缝合钩过线法进行比较。方法选取2017年9月至2020年8月于芜湖市第一人民医院收治的68例肩袖损伤病人，按照随机数字表法分为穿刺针组(23例)、缝合枪组(23例)、缝合钩组(22例)。三组病人均采用关节镜下双排锚钉固定修复术治疗，穿刺针组采用硬膜外穿刺针反向穿线法过线、缝合枪组采用缝合枪过线、缝合钩组采用缝合钩过线。比较三组病人手术时间、术后疼痛、肩关节功能和住院费用。结果穿刺针组、缝合枪组、缝合钩组病人手术时间分别为(89.43±10.15)min、(88.75±11.23)min、(115.42±16.48)min；术后24 h疼痛(视觉模拟评分法VAS)评分分别为(2.51±1.32)分、(2.64±1.21)分、(3.58±1.52)分；术后6月肩关节功能(UCLA)评分分别为(33.12±2.23)分、(32.85±2.15)分、(30.17±2.44)分，住院费用分别为(25 430.4±824.3)元、(31 280.7±526.9)元、(26 730.2±624.5)元。穿刺针组与缝合枪组在手术时间、术后疼痛及关节功能恢复等方面比较差异无统计学意义(P>0.05)，在住院费用方面比较差异有统计学意义(P<0.05)；穿刺针组与缝合钩组在手术时间、术后疼痛、关节功能恢复、手术费用等方面比较均差异有统计学意义(P<0.05)。结论与缝合枪过线比较，硬膜外穿刺针反向过线临床应用效果与缝合枪过线相当，具有节约成本的优势。

Application of the epidural needle reverse threading method in the arthroscopic treatment of rotator cuff injury

Objective To observe the application effect of the reverse threading method of epidural puncture needles in the ar-throscopic treatment of rotator cuff injuries and compare it with the suture gun threading method and the suture hook threading method.Methods A total of 68 patients with rotator cuff injury who were admitted to Wuhu No.1 People''s Hospital from September 2017 toAugust 2020 were selected and divided into a puncture needle group (23 cases), suture gun group (23 cases) and suture hook group (22cases) according to the random number table method. All three groups of patients were treated with arthroscopic double-row anchor fixa-tion and repair. In the puncture needle group, the reverse threading method of the epidural puncture needle was used to pass the suture,the suture gun group was used to pass the suture gun, and the suture hook group was used to pass the suture hook. The operation time,postoperative pain, shoulder function and hospitalization cost were compared among the three groups.Results The operation time of the patients in the puncture needle group, suture gun group and suture hook group were (89.43±10.15)min,(88.75 ±11.23)min and(115.42±16.48)min, respectively; the 24-hour postoperative pain (visual analog scale) scores were (2.51±1.32),(2.64±1.21) and (3.58±1.52),respectively; the shoulder joint function (UCLA) scores at 6 months after the operation were (33.12±2.23),(32.85±2.15) and(30.17±2.44),respectively; and the hospitalization expenses were (25 430.4±824.3)CNY,(31 280.7±526.9)CNY and (26 730.2±624.5)CNY, respectively.There was no significant difference in operation time, postoperative pain or joint function recovery between the punc-ture needle group and the suture gun group (P>0.05), but there was a significant difference in hospitalization cost (P<0.05). There were significant differences in operation time, postoperative pain, joint function recovery and operation cost between the puncture needle group and the suture hook group (P<0.05).Conclusion Compared with the suture gun thread, the clinical application effect of epidur-al needle reverse thread is equivalent to that of the suture gun thread, and it has the advantage of cost savings.