Summary

Abstract

Objective

采用 Meta 分析法对关节镜下单排固定与双排固定治疗肩袖撕裂的疗效进行对比， 为其广泛的临床应用提供循证证据。 To evaluate the effects of arthroscopic single － row versus double － row fixation in treating rotator cuff tear， so as to provide evidence － based information for its clinical application．
Method(s):
检索 PubMed、 SpringerLink、 EMBASE、 the Cochrane Library、 Medline、 ScienceDirect、 中国知识资源总库、 万方数据库、 维普数据库， 检索时间段为 1970 年 1 月 ～ 2014 年 6 月，收集关节镜下单排固定与双排固定治疗肩袖撕裂疗效对比的相关文1献， 按纳入与排除标准筛选文献并对纳入文献进行质量评价， 采用 ＲevMan5.2 软件进行分析。 Eligible studies were identified from electronic databases including PubMed， SpringerLink， EMBASE， the Cochrane Library，Medline， Science Direct， CNKI， WanFang data and VIP data． The retrieved literature was #S#ed according to the inclusion and exclusion criteria and a meta analysis was performed with the software ＲevMan 5． 2 after identification of the relevant data．
Result(s):
共纳入 13 篇文献， 病例数合计为 840 例， 其中关节镜下单排固定组 427 例，双排固定组 413 例。结果显示在主要观察指标中，关节镜下单排固定术后肩袖再撕裂的风险高于双排固定组( OＲ = 2． 31，95% CI: ［ 1． 57，3． 39］，P ＜ 0． 001) ， 单排固定组术后 ASES( the American shoulder and elbow surgeons scores) 评分( MD = － 0． 85，95% CI: ［ － 1． 66， － 0． 03］，P = 0． 04) 及术后UCLA( the University of California， Los Angeles score) 评分( MD = － 0． 85， 95% CI: ［ － 1． 27， － 0． 20］， P =0. 007) 分别低于双排固定组术后评分，而术后 Constant 评分及 WOＲC 评分两组间差异无统计学意义; 在次要观察指标分析中，双排固定组在前屈活动度、 肩关节外展、 肩关节内旋方面优于单排固定组( P ＜ 0． 05) ， 在术后患者满意度、 外旋活动度、 肩关节外旋等指标两组之间无统计学意义( P ＞ 0． 05) 。 Thirteen studies met our inclusion criteria， including 427 cases in the single － row fixation group and 413 cases in the double － row fixation group． The re － tear risk of the single row fixation group was higher than that of the double － row fixation group( P ＜ 0． 001) ． The ASES score( the American shoulder and elbow surgeons scores) and UCLA score ( the University of California， Los Angeles score) in the single － row fixation group were lower than those of the double － row fixation group， but the Constant score and WOＲC score ( the Western Ontario rotator cuff index score) were found to have no statistical difference． The forward flexion motion， shoulder external rotation and shoulder internal rotation were better in the double － row fixation group than those of the single － row fixation group( P ＜ 0． 05) ， while there was no statistical difference in indicators such as patients' satisfaction， internal rotation motion， external rotation motion and shoulder internal rotation ( P ＞ 0． 05)
Conclusion(s):
关节镜下双排固定治疗肩袖撕裂，术后发生肩袖再次撕裂的风险低于单排固定， 在术后 ASES 评分、 UCLA 评分、 前屈活动度、 肩关节外展、 肩关节内旋等方面优于单排固定， 尚无证据表明两组在 Constant 评分、 WOＲC 评分、 术后患者满意度、 内旋活动度、 外旋活动度、 肩关节外旋方面有明显差异。 Double － row fixation for treating rotator cuff tear has lower risk of re － tear and can obtain better results in the ASES score， UCLA score，shoulder abductor motion and shoulder internal rotation． However， there is no detectable difference in the Constant score，WOＲC score， satisfaction， internal rotation motion， external rotation motion and shoulder external rotation between single － row and double － row fixations