关节镜下完全清理钙化灶术对肩袖钙化性肌腱炎病人术后ASES、VAS及Constant-Murley评分的影响

迟立平; 王芳; 魏海强

doi:10.13898/j.cnki.issn.1000-2200.2022.07.008

关节镜下完全清理钙化灶术对肩袖钙化性肌腱炎病人术后ASES、VAS及Constant-Murley评分的影响

Effect of complete arthroscopic debridement of calcified foci surgery on postoperative ASES, VAS and Constant-Murley scores in patients with rotator cuff calcific tendinitis of the shoulder

摘要

摘要:
目的分析关节镜下完全清理钙化灶术对肩袖钙化性肌腱炎病人术后美国肩肘协会评分系统评分(ASES)、疼痛视觉模拟评分(VAS)及肩关节功能Constant-Murley评分的影响。
方法收集63例肩袖钙化性肌腱炎病人的临床治疗资料, 其中行关节镜下完全清理钙化灶术者31例作为观察组, 行关节镜下部分清理钙化灶术者32例作为对照组。比较2组手术时间、住院时间、主动最大活动度时间、被动最大活动度时间和术前及术后1、2、6、12个月的ASES、VAS及Constant-Murley评分。
结果观察组住院时间、主动最大活动度时间及被动最大活动度时间均明显长于对照组(P < 0.01), 2组手术时间差异无统计意义(P>0.05)。2组术后1、2、6、12个月的ASES评分均高于术前(P < 0.05), 且观察组术后1、2个月ASES评分均明显低于对照组(P < 0.01), 但2组术后6、12个月ASES评分差异均无统计学意义(P>0.05)。2组术后1、2、6、12个月的VAS评分均低于术前(P < 0.05), 且观察组术后1、2、6个月VAS评分均明显高于对照组(P < 0.01), 但2组术后12个月VAS评分差异无统计学意义(P>0.05)。2组术后1、2、6、12个月的Constant-Murley评分均高于术前(P < 0.05), 且观察组术后1、2个月Constant-Murley评分均明显低于对照组(P < 0.01), 但2组术后6、12个月Constant-Murley评分差异均无统计学意义(P>0.05)。
结论关节镜下完全清理钙化灶术应用于肩袖钙化性肌腱炎, 对病人术后远期ASES、VAS及Constant-Murley评分的改善效果与关节镜下部分清理钙化灶术相当, 但近期效果弱于关节镜下部分清理钙化灶术, 临床可根据病人具体情况灵活选择术式。

Abstract:
ObjectiveTo analyze the effects of complete arthroscopic debridement of calcified foci surgery on postoperative American shoulder and elbow scoring system(ASES), visual analogue scale(VAS) and Constant-Murley scores in patients with rotator cuff calcific tendinitis of the shoulder.
MethodsThe clinical data of 63 patients with rotator cuff calcific tendinitis of the shoulder were collected.Among them, 31 patients undergoing complete arthroscopic debridement of calcified foci surgery were set as the observation group, and 32 patients undergoing partial arthroscopic debridement of calcified foci surgery were set as the control group.The operation time, hospitalization time, active maximum activity time, passive maximum activity time, and ASES, VAS and Constant-Murley scores before operation and at 1, 2, 6, and 12 months after operation were compared between the two groups.
ResultsThe hospitalization time, active maximum activity time and passive maximum activity time in observation group were significantly longer than those in control group(P < 0.01).There was no significant difference in operation time between the two groups(P>0.05).The ASES scores in the two groups at 1, 2, 6, and 12 months after operation were higher than those before operation(P < 0.05), and the ASES scores in observation group at 1 month and 2 months after operation were significantly lower than those in control group(P < 0.01), but there was no significant difference in ASES scores between the two groups at 6 months and 12 months after operation(P>0.05).The VAS scores in the two groups at 1, 2, 6, and 12 months after operation were lower than those before operation(P < 0.05), and the VAS scores in observation group at 1, 2, and 6 months after operation were significantly higher than those in control group(P < 0.01), but there was no significant difference in VAS scores between the two groups at 12 months after operation(P>0.05).The Constant-Murley scores in the two groups at 1, 2, 6, and 12 months after operation were higher than those before operation(P < 0.05), and the Constant-Murley scores in observation group at 1 month and 2 months after operation were significantly lower than those in control group(P < 0.01), but there was no significant difference in Constant-Murley scores between the two groups at 6 months and 12 months after operation(P>0.05).
ConclusionsThe application of complete arthroscopic debridement of calcified foci surgery in rotator cuff calcific tendinitis of the shoulder has the same effect in the long-term after operation on the improvement of ASES, VAS and Constant-Murley scores with partial arthroscopic debridement of calcified foci surgery, but the short-term effect is weaker than that of partial arthroscopic debridement of calcified foci surgery.The surgery method can be flexibly selected according to the specific conditions of patients in clinic.

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