CAJ | 학술논문

目的探讨关节镜下使用缝合桥(suture bridge)技术治疗肩袖全层撕裂伤术后综合康复治疗的临床疗效.方法将41例肩袖全层撕裂患者,按随机数字表法分为治疗组(21例)和对照组(20例).2组均采用关节镜下双排缝合桥技术进行肩袖修补术,治疗组在术后采用包括康复教育、物理因子治疗和康复功能训练的系统化综合康复治疗,对照组则进行包括牵伸和肌力训练的常规康复治疗.分别于治疗前和治疗6个月后,采用疼痛视觉模拟评分(VAS)、肩关节前屈和体侧外旋的关节活动度(ROM)、美国加州大学洛杉矶分校(UCLA)肩关节评分系统及美国肩肘外科医师协会(ASES)评分标准,对2组患者进行疗效评价,观察术后6个月功能恢复情况,并与治疗前相应指标进行统计学分析比较.结果 2组患者术后平均随访15.6个月(8～ 24个月).治疗前2组各评价指标差异无统计学意义(P＞0.05).术后6个月随访时,治疗组VAS疼痛评分为(1.7±1.5)分,前屈和外旋的ROM分别为(168.3 ±31.3)°和(47.2±11.2)°,UCLA和ASES评分分别为(30.7±4.13)和(85.1 ±15.67)分,较对照组[(3.8±2.2)分、(121.2 ±53.6)°、(32.9±14.9)°、(18.3±4.94)分、(36.4 ±17.70)分]有明显改善(P＜0.05),且2组治疗后分别与组内治疗前比较,差异有统计学意义(P＜0.05).结论经过系统康复治疗,可以使接受肩关节镜下双排缝合桥技术行肩袖修补术后的患者恢复良好的功能活动.
목적 탐토관절경하사용봉합교(suture bridge)기술치료견수전층시렬상술후종합강복치료적림상료효.방법 장41례견수전층시렬환자,안수궤수자표법분위치료조(21례)화대조조(20례).2조균채용관절경하쌍배봉합교기술진행견수수보술,치료조재술후채용포괄강복교육、물리인자치료화강복공능훈련적계통화종합강복치료,대조조칙진행포괄견신화기력훈련적상규강복치료.분별우치료전화치료6개월후,채용동통시각모의평분(VAS)、견관절전굴화체측외선적관절활동도(ROM)、미국가주대학락삼기분교(UCLA)견관절평분계통급미국견주외과의사협회(ASES)평분표준,대2조환자진행료효평개,관찰술후6개월공능회복정황,병여치료전상응지표진행통계학분석비교.결과 2조환자술후평균수방15.6개월(8～ 24개월).치료전2조각평개지표차이무통계학의의(P＞0.05).술후6개월수방시,치료조VAS동통평분위(1.7±1.5)분,전굴화외선적ROM분별위(168.3 ±31.3)°화(47.2±11.2)°,UCLA화ASES평분분별위(30.7±4.13)화(85.1 ±15.67)분,교대조조[(3.8±2.2)분、(121.2 ±53.6)°、(32.9±14.9)°、(18.3±4.94)분、(36.4 ±17.70)분]유명현개선(P＜0.05),차2조치료후분별여조내치료전비교,차이유통계학의의(P＜0.05).결론 경과계통강복치료,가이사접수견관절경하쌍배봉합교기술행견수수보술후적환자회복량호적공능활동.
Objective To evaluate and analyze the clinical effect of comprehensive rehabilitation therapy after arthroscopic rotator cuff repair using suture-bridge technique for full-thickness rotator cuff tears.Methods Forty-one patients (20 males,21 females; mean age 52.2 years) with full-thickness rotator cuff tears were treated with arthroscopic rotator cuff repair using suture-bridge technique between June 2010 and January 2012 in our hospital.After arthroscopic rotator cuff repair,the patients were randomly assigned to a treatment group (21 patients) or a control group (20 patients).The treatment group received systematic rehabilitation therapy including rehabilitation education,physical modalities treatment and rehabilitative training additionally,while the control group only accepted the routine rehabilitation therapy including stretching and muscle strength training.The outcome was evaluated at 6 months after surgery,by employing visual analogae scale (VAS),the range of motion (ROM) testing of shoulder joint flexion and rotation,the rating scale of University of California at Los Angeles (UCLA),and the shoulder index of American shoulder and elbow surgeons (ASES).Results The mean follow-up period was 15.6 months (8-24 months).Prior to intervention,there was no significant difference in any parameter between the two groups (P ＞ 0.05).Six months later,all scores of assessments changed:in treatment group VAS (1.7 ± 1.5),ROM [flexion (168.3±31.3)°,rotation (47.2±11.2)°],UCLA(30.7 ±4.13) and ASES (85.1 ±15.67); in control group VAS(3.8±2.2),ROM[flexion (121.2 ±53.6)°,rotation (32.9 ±14.9)°],UCLA(18.3 ±4.94) and ASES (36.4 ± 17.70).Significant changes occurred in both groups in all the parameters after treatment when compare to baseline (P ＜ 0.05).Conclusions Comprehensive rehabilitation therapy is an effective approach for improving motor ability of the shoulder in patients after arthroscopic rotator cuff repair with suture-bridge technique for their full-thickness rotator cuff tears.