是否保留肩袖对肩巨大钙化性肌腱炎手术疗效的影响_医学论文.docVIP

是否保留肩袖对肩巨大钙化性肌腱炎手术疗效的影响_医学论文 是否保留肩袖对肩巨大钙化性肌腱炎手术疗效的影响_医学论文 作者：贺业腾，闫新峰，张明，王呈，朱本珂【摘要】 ［目的］通过对2组肩巨大钙化性肌腱炎病人以保留和不保留肩袖2种术式的手术疗效的观察，探讨分析术中肩袖的完整性及钙化灶清除是否彻底对治疗效果的影响。［方法］自2004年10月～2006年11月采用肩关节镜治疗肩关节巨大钙化性肌腱炎15例15肩，男6例，女9例；平均44.7岁；术前Constant评分平均56（49～62）分；其中8例术中保留近关节面侧肩袖的完整，允许少量钙化灶残留，7例彻底清除钙化灶并缝合破坏后的肩袖。平均随访时间16.7（3～25）个月。对手术方式、钙化灶的残留对临床效果的影响进行分析。［结果］全部获得完整随访资料，术后疼痛明显好转或消失13例，疼痛缓解2例。Constant评分保留肩袖组平均91（81～95）分，肩袖缝合组平均90.2（80～94）分。保留肩袖组除3例术后X线片可见少量钙化灶外，其余5例术后残留钙化灶并未在X线片上显影，且3例显影者术后3个月拍片复查发现残留钙化灶皆消失。［结论］两种手术方法皆有很好的疗效，两组病人手术效果无明显差异，但保留肩袖组具有手术方式简单、花费少、创伤小、恢复快等优点。 【关键词】 肩关节镜； 钙化； 肌腱炎； 肩峰； 肩袖 Abstract：［Objective］To observe the clinical outcome of rotator cuffreserved calcium deposit removal on extensive shoulder calcific tendinitis.To discuss if it is necessary to sacrifce the cuff integrity for a completely removal of calcium deposit.［Method］From Oct.2004 to Apr.2006,15 cases（15 shoulders）of extansive shoulder rotator cuff calcific tendinitis were treated with calcium removal under arthroseopy.Among them there were 6 males and 9 females with an average age of 44.7.The average preoperative evaluation grade with ConstantMurley were 56（49～62）.During the operation,the rotator cuff integrity were reserved in 8 cases and most of the deposits were removed with some calcium left in the reserved cuff layer.In the other 7 cases,complete deposit clearance were performed and the rotator cuff was repaired subsequently,average followup were 16.7 months（3～25）.The Constantand the changes of remnant calcium were observed.［Result］13 cases reported significant pain dissolved and 2 reported pain relieved.The average postoperative Constant（81～95）,while the cuff（80～94）.On postoperative radiograph,only 3 cases demonstrated remnant deposit,and disappeared within 3 months after operation.［Conclusion］Both of the two kinds of operations showed good clinical outcome.The rotator cuffimplified operation techniques,less costs and fewer complications.It is unnecessary to sacrifice cuffintegrity for complete