Summary

关节镜下两种方法治疗老年II型SLAP损伤效果比较

Abstract

Objective

比较关节镜下单纯肱二头肌长头腱切断术与常规关节镜下带线铆钉修补固定术两种方法治疗老年II型SLAP损伤的术后效果差异。 To investigate and compare the clinical effects between two treatment under arthroscopy for type II SLAP patients older than 65 years.
Method(s):
回顾2013年9月至2014年12月期间的72例老年SLAP损伤患者，A组34例采用关节镜下单纯肱二头肌长头腱切断术，B组38例采用常规关节镜下带线铆钉修补固定术。随访1年，进行术后2周及1年视觉模糊疼痛评分（VAS）和腕肩手失能评分（DASH），结果间通过SPSS20.0软件进行X2检验及配对t检验。 We reviewed 72 cases of patients underwent type II SLAP during the period from 2013 September to 2014 December, Group A (34 patients) received biceps tenotomy under arthroscopic therapy, Group B (38 cases) received conventional repair and fixation by silk-rivets under arthroscopy. During 1 years of follow-up, the VAS scores and DASH scores(disablement of arm, shoulder and hand) were recorded and compared by SPSS 20.0.
Result(s):
72例患者均得到随访，随访时间为1.1±0.07年。两组间在性别、年龄、术前VAS疼痛评分、DASH评分等方面无明显统计学差异。两组术后1年VAS评分及DASH评分较术后2周均有改善，具有明显统计学意义。术后1年A组患者26.4% (10/34)出现“牛眼征”，13.2%（5/34）进行过1次关节腔封闭治疗，0例进行过第2次关节腔封闭；B组患者出现0例牛眼征，50%（19/38）进行过至少1次关节腔封闭治疗，15.9%（6/38）进行过第2次关节腔封闭治疗，0例进行过第3次关节腔关节封闭治疗。术后2周的VAS评分及DASH评分：A组5.14±0.87和40.05±16.76，B组7.16±1.09和70.42±16.93。VAS评分和DASH评分在A组和B组间存在统计学差异（p＜0.05）；术后1年的VAS评分及DASH评分：A组为1.35±0.98和10.35±3.05，B组为1.45±0.79和10.76±2.97，VAS评分和DASH评分在A组和B组间无统计学差异（p＞0.05）。 72 patients were all followed up, and the following-up time was 1.1±0.07 years. The VAS score and DASH score after 2 weeks were: Group A was 5.14±0.87 and 40.05±16.76, Group B was 7.16±1.09 and 70.42±16.93. The VAS score and DASH score of Group A and B had significant difference（p＜0.05）. The VAS score and DASH score after 1 year were: Group A was 1.35±0.98 and 10.35±3.05, Group B was 1.45±0.79 and 10.76±2.97. The VAS score and DASH score of Group A and B had no significant difference（p＞0.05）.
Conclusion(s):
对于老年II型SLAP损伤，选择关节镜下单纯肱二头肌长头腱切断术还是带线铆钉修补固定术，并无差别。由于前者术程简单，术后恢复快，住院费用低，对于身体状况较差、经济状况较差的老年患者，更适合使用。 The clinical effects were similar between two treatment under arthroscopy for type II SLAP patients older than 65 years. Biceps tenotomy under arthroscopic therapy has superiority with simple operation, short hospitalization time, less perioperative complications and less expense.