关节镜下改良前肩峰成形术治疗肩峰下撞击综合征的临床研究

摘要

目的：考察关节镜下改良前肩峰成形术治疗肩峰下撞击综合征的临床效果。方法选择徐州市中心医院于2012年1月~2014年12月收治的32例肩峰下撞击综合征患者，按照随机分组系统RandA 1.0分为改良组与对照组，每组各16例。对照组采用常规关节镜下前肩峰成形术治疗，改良组在对照组基础上增加关节镜下改良前肩峰成形术治疗。观察并比较两组的治疗效果。结果改良组术后X线片显示肩峰成形充分，且其局部骨质经术中打磨后显示为暗区；术后随访平均(9.64±3.92)个月，两组患者的术后美国肩肘外科学会肩关节评分标准(ASES)评分及加利福尼亚大学洛杉矶评分标准(UCLA)评分均较术前获得显著提升，差异均有统计学意义(P<0.05或P<0.01)，且改良组的评分改善效果更为明显，与对照组比较差异有统计学意义(P<0.05)；改良组优良率为93.75%，对照组优良率为87.50%，两组比较差异有统计学意义(P<0.05)。结论肩关节镜下改良前肩峰成形术对肩峰下撞击综合征的临床治疗效果是值得肯定的，在满足手术适应证的情况下建议将该术式作为临床治疗肩峰下撞击综合征的首选术式。%Objective To investigate the clinical effect of arthroscopic improved foreacromioplasty for the treatment of subacromial impingement syndrome. Methods From January 2012 to December 2014, in the Central Hospital of Xuzhou City, 32 cases patients with subacromial impingement syndrome were selected, according to random system RandA 1.0, all the patients were divided into control group and improvement group, with 16 cases in each group. The control group was treated with routine arthroscopic anterior acromioplasty, the improvement group was treated by arthro-scopic improved foreacromioplasty. The clinical effect of two groups were observed and compared. Results The X-ray film of improvement group showed acromioplasty full, and the local bone was displayed as the dark area after the oper-ation. Followed up for average (9.64±3.92) months postoperatively, the postoperative ASES score and UCLA score of the two groups were improved and the differences were statistically significant (P<0.05 or P< 0.01), and the improvement effect of improvement group was more notable, compared with the control group, the differences were statistically signif-icant (P<0.05). The good rate of control group and improvement group were 87.50%, 93.75%, the difference was sta-tistically significant (P<0.05). Conclusion The clinical effect of arthroscopic improved foreacromioplasty for subacro-mial impingement syndrome is positive, the arthroscopic improved foreacromioplasty should as the first choice for the treatment of subacromial impingement syndrome when meet the surgical indications suggest.