不同损伤时间的肩袖撕裂合并冻结肩患者采用手法松解辅助关节镜手术治疗的效果比较
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安徽省蚌埠市卫生健康委科研项目(BBWK2023A202);


Comparison of the effects of manual release combined with arthroscopic surgery in patients with rotator cuff tears and frozen shoulder at different injury times
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    摘要:

    目的:比较不同损伤时间的肩袖撕裂合并冻结肩患者采用手法松解辅助关节镜手术治疗的效果。方法:回顾性分析86例肩袖撕裂合并冻结肩患者的临床资料,根据其损伤时间将患者分为A组(肩袖撕裂时间<3个月,n=44)和B组(3个月≤肩袖撕裂时间≤6个月,n=42)。两组患者均采用手法松解辅助关节镜手术治疗,比较其手术指标(手术时间及术中出血量),治疗前后疼痛情况、肩关节活动度(包括前屈和外旋)、美国加州大学肩关节功能评分系统(UCLA)、美国肩肘协会评分系统(ASES)及并发症发生情况。结果:两组手术指标差异无统计学意义(P>0.05)。术后1个月和3个月两组疼痛视觉模拟评分(VAS)均降低(P<0.05),肩关节活动度均增大(P<0.05),UCLA、ASES评分均升高(P<0.05);且术后1个月A组VAS疼痛评分低于B组(P<0.05),肩关节活动度大于B组(P<0.05),UCLA、ASES评分均高于B组(P<0.05);术后3个月两组VAS疼痛评分、肩关节活动度及UCLA、ASES评分无统计学差异(P>0.05)。两组术后均未见神经损伤、感染及手法松解相关并发症。结论:与肩袖撕裂时间处于3~6个月的肩袖撕裂合并冻结肩患者相比,肩袖撕裂时间<3个月的患者采用手法松解辅助关节镜手术治疗后早期症状缓解效果更显著,肩关节活动度更佳,但远期效果趋于一致。

    Abstract:

    Objective:To compare the effects of manual release assisted arthroscopic surgery in patients with rotator cuff tears and frozen shoulder at different injury times.Methods:A retrospective analysis was conducted on 86 patients with rotator cuff tears and frozen shoulder,patients were divided into two groups based on the time since injury:group A(rotator cuff tear<3 months,n=44)and group B(3 months ≤ rotator cuff tear ≤6 months,n=42).Both groups underwent MUA-assisted arthroscopic surgery.Surgical in-dicators(operation time and intraoperative blood loss),pain levels before and after treatment,range of motion of the shoulder joint(in-cluding forward flexion and external rotation),University of California Los Angeles(UCLA)Shoulder Score,American Shoulder and El-bow Surgeons(ASES)score,and complications were compared between the two groups.Results:There were no significant differences in surgical indicators between group A and group B(P>0.05).At 1 and 3 month postoperatively,both groups showed reduced Visual Analog Scale(VAS)pain scores(P<0.05),increased range of shoulder motion(P<0.05),and improved UCLA and ASES scores(P<0.05).Furthermore,at 1 month postoperatively,group A had lower VAS pain scores(P<0.05),greater range of shoulder motion(P<0.05),and higher UCLA and ASES scores(P<0.05)compared to group B.At 3 months postoperatively,there were no signifi-cant differences in VAS pain scores,range of shoulder motion,and UCLA and ASES scores between group A and group B(P>0.05).No nerve injuries,infections,or complications related to MUA were observed in either group postoperatively.Conclusion:Compared to patients with rotator cuff tears and frozen shoulder who have the injury for 3 to 6 months,those with an injury duration of less than 3 months showed more significant early symptom relief and better shoulder mobility when treated with MUA-assisted arthroscopic surgery,although long-term outcomes tend to be consistent.

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朱斌;范瑞;熊风;钱锋;.不同损伤时间的肩袖撕裂合并冻结肩患者采用手法松解辅助关节镜手术治疗的效果比较[J].川北医学院学报,2025,40(4):501-504.

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  • 在线发布日期: 2025-07-24
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