CAJ | 학술논문

背景：肩袖修复的常见方式有单排缝合法和双排缝合法。既往有报道双排缝合法在临床上并未显示出比单排缝合更优的效果。 　　目的：比较肩袖损伤中单排与双排缝合方法的临床效果，评价两种方法的疗效差异。 　　方法：检索Medline(2003年1月至2014年2月)、Embase (2003年1月至2014年2月)、Cochrane library (2014年2月)等数据库，按照纳入标准和排除标准收集比较肩袖损伤中单排与双排缝合方法的随机对照研究，系统评价各研究方法学质量，并采用Revman5.2进行Meta分析。比较单双排缝合两组治疗方法的constant， ASES(American Shoulder and Elbow Surgeons Scale)，UCLA(University of California, Los Angeles score)治疗前后评分差异，肩袖再断裂率，肩袖肌力恢复情况，以森林图回顾两组数据比较情况及行漏斗图检测其发表偏倚情况。 　　结果与结论：共纳入10个随机对照试验(LevelsⅠ，Ⅱ)，Meta 分析结果显示：双排缝合组与单排缝合组的constant评分，ASES评分及UCLA评分治疗前后比较无明显差别；在治疗后随访结果上：双排缝合治疗后肩袖再断裂率概率低于单排缝合，外展肌力双排缝合组优于单排缝合组。在肩袖撕裂小于3 cm的亚组中，双排缝合组与单排缝合组在constant评分，ASES评分、UCLA评分比较上无明显差别。在肩袖撕裂大于3 cm的亚组中，双排缝合组较单排缝合组在ASES评分、UCLA评分比较上显示出更优效果。结果表明肩袖损伤的患者采用双排缝合相对于单排缝合法治疗后肩袖再撕裂率更低，外展肌力恢复情况更优。小于3 cm肩袖损伤单双排缝合法治疗后功能评分无明显差异，大于3 cm的肩袖损伤采用双排缝合法可取得更佳的治疗后功能评分。
배경：견수수복적상견방식유단배봉합법화쌍배봉합법。기왕유보도쌍배봉합법재림상상병미현시출비단배봉합경우적효과。 　　목적：비교견수손상중단배여쌍배봉합방법적림상효과，평개량충방법적료효차이。 　　방법：검색Medline(2003년1월지2014년2월)、Embase (2003년1월지2014년2월)、Cochrane library (2014년2월)등수거고，안조납입표준화배제표준수집비교견수손상중단배여쌍배봉합방법적수궤대조연구，계통평개각연구방법학질량，병채용Revman5.2진행Meta분석。비교단쌍배봉합량조치료방법적constant， ASES(American Shoulder and Elbow Surgeons Scale)，UCLA(University of California, Los Angeles score)치료전후평분차이，견수재단렬솔，견수기력회복정황，이삼림도회고량조수거비교정황급행루두도검측기발표편의정황。 　　결과여결론：공납입10개수궤대조시험(LevelsⅠ，Ⅱ)，Meta 분석결과현시：쌍배봉합조여단배봉합조적constant평분，ASES평분급UCLA평분치료전후비교무명현차별；재치료후수방결과상：쌍배봉합치료후견수재단렬솔개솔저우단배봉합，외전기력쌍배봉합조우우단배봉합조。재견수시렬소우3 cm적아조중，쌍배봉합조여단배봉합조재constant평분，ASES평분、UCLA평분비교상무명현차별。재견수시렬대우3 cm적아조중，쌍배봉합조교단배봉합조재ASES평분、UCLA평분비교상현시출경우효과。결과표명견수손상적환자채용쌍배봉합상대우단배봉합법치료후견수재시렬솔경저，외전기력회복정황경우。소우3 cm견수손상단쌍배봉합법치료후공능평분무명현차이，대우3 cm적견수손상채용쌍배봉합법가취득경가적치료후공능평분。
BACKGROUND:Single-row and double-row suture method are commonly used in the rotator cuff repair. Previous studies have shown that, double-row suture is not better than single-row suture in clinics. OBJECTIVE:To compare clinical outcomes of single-row suture and double-row suture for rotator cuff repair, and evaluate the difference of therapeutic efficacy between two methods. METHODS:A computer-based search was performed in the Medline (from January 2003 to February 2014), EMBASE (from January 2003 to February 2014) and Cochrane library (February 2014). According to the inclusion and exclusion criteria, al the randomized control ed studies addressing the outcome of single-row repair and double-row repair techniques were included in this meta-analysis. The methodological quality of each study was judged and a meta-analysis was conducted using Revman5.0. The preoperative and postoperative differences between the Constant score, American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles (UCLA) score, the re-rupture rate and the muscle strength were compared. The forest chart was used to compare the data between two groups, and the funnel plot was finished to detect the publication bias. RESULTS AND CONCLUSION:A total of 10 randomized control ed trials (Levels I, II) were included. Meta-analysis showed that, there was no statistical y significant difference in the Constant, ASES and UCLA scores in the double-row group and the single-row group before and after treatment. In the postoperative fol ow-up, double-row group had a lower re-rupture rate and a higher abductor muscle strength than single-row group. When the rotator cuff tear was less than 3 cm, double-row group had no significant difference with the single-row suture group. While in the over 3-cm tear group, double-row group showed better results than the single-row suture group on the Constant scpre, ASES score and UCLA score. Double-row suture has a low re-rupture rate than single-row suture in rotator cuff injury, and could achieve better abduction muscle strength. There is no significant difference in the functional score between double-row suture and single-row suture in the rotator cuff tear of less than 3 cm, while in the over 3-cm tear, double-row suture could achieve better functional score.