肩关节镜下双排缝线桥修复技术对肩袖撕裂患者炎症反应和肩关节功能的影响

Effect of shoulder arthroscopic double row suture bridge repair program on inflammatory reaction and shoulder function in rotator cuff tears patients

摘要:

目的 评估肩关节镜下双排缝线桥修复技术治疗肩袖撕裂的临床疗效。方法 选取2019年9月－2023年7月该院收治的肩袖撕裂患者118例，采用随机数表法，将患者分为对照组和试验组，各59例，两组各失访1例，最终两组各纳入58例。两组均于全身麻醉下行肩关节镜下肩袖修复术，对照组采用单排固定缝合技术，试验组采用双排缝线桥修复技术，术后随访6个月。比较两组患者手术相关情况、疼痛程度［视觉模拟评分法（VAS）评分］、肩关节功能［Constant-Murley评分、美国加州大学洛杉矶分校（UCLA）评分和美国肩肘外科协会（ASES）评分］、肩关节活动度、炎症反应［C反应蛋白（CRP）、转化生长因子-β1（TGF-β1）和白细胞介素-6（IL-6）］和安全性。结果 试验组手术时间较对照组短，差异有统计学意义（P < 0.05）；两组患者术后6个月的VAS评分较术前明显降低，且试验组低于对照组，差异均有统计学意义（P < 0.05）；两组患者术后6个月的Constant-Murley评分、UCLA评分和ASES评分较术前升高，且试验组高于对照组，差异均有统计学意义（P < 0.05）；两组患者术后6个月的肩关节活动度较术前增大，且试验组大于对照组，差异均有统计学意义（P < 0.05）；两组患者术后3 d的CRP、TGF-β1和IL-6较术前升高，且试验组低于对照组，差异均有统计学意义（P < 0.05）；试验组肩袖再撕裂和关节僵硬发生率为3.45%和3.45%，明显低于对照组的13.79%和18.97%，差异均有统计学意义（P < 0.05）。结论 肩袖撕裂患者应用双排缝线桥修复技术，可缩短手术时间，减轻术后炎症应激反应和疼痛，加大肩关节活动度，促进肩关节功能恢复，并可减少肩袖再撕裂和关节僵硬的发生。

Abstract:

Objective To evaluate the efficacy of shoulder arthroscopic double row suture bridge repair program in patients with rotator cuff tears.Methods 118 cases of rotator cuff tear patients admitted from September 2019 to July 2023 were selected, then they were divided in the control group and pilot group, each with 59 cases (the random number table method was used as the basis for dividing the groups), and each of two groups 1 case was lost, and finally 58 cases were included in each. Both underwent shoulder arthroscopic rotator cuff repair under general anesthesia, the control group was treated with single-row fixed suture, the pilot group was treated with double row suture bridge repair program, and were followed up for 6 months after surgery. Two groups were compared operative-related conditions, pain [visual analogue scale (VAS) score], shoulder function [the Constant-Murley scale, University of California at Los Angeles (UCLA) scale, American Shoulder and Elbow Surgeons (ASES) scale], shoulder mobility, inflammatory reaction [C reactive protein (CRP), transforming growth factor-β1 (TGF-β1) and interleukin-6 (IL-6)] and safety.Results Compared to control group, surgery time of the pilot group was shorter, the difference was statistically significant (P < 0.05); Compared to before surgery, VAS score in two groups 6 months after surgery was lower, the pilot group was lower than that of control group, the differences were statistically significant (P < 0.05); Constant-Murley scale, UCLA scale and ASES scale of pilot group 6 months after surgery were higher than those of control group, and the shoulder joint mobility 6 months after surgery was bigger than that of control group, the differences were statistically significant (P < 0.05); CRP, TGF-β1, IL-6 3 days after surgery in two groups were higher than those before surgery, but the pilot group was lower than control group, the differences were statistically significant (P < 0.05); Compared to control group (13.79% and 18.97%), the incidence of rotator cuff re-tear and joint stiffness were lower in the pilot group (3.45% and 3.45%), the differences were statistically significant (P < 0.05).Conclusion The application of double-row suture bridge repair technique in patients with rotator cuff tear could shorten the operation time, reduce the postoperative inflammatory stress and pain, improve the shoulder mobility, restore the shoulder function, and reduce the occurrence of rotator cuff re-tear and joint stiffness.