摘要
目的探讨快速康复外科理念在关节镜下治疗肩袖损伤中的应用效果。方法回顾性分析自2015年2月至2016年8月咸宁市中心医院关节外科收治的肩袖损伤患者37例,所有患者术前诊断为单纯肩袖损伤并在关节镜下行肩袖缝合修补术。随机将37例无合并严重内科疾患的单纯肩袖损伤患者分为快速康复组(FTS)和传统康复组(TRG),其中FTS组19例,男10例,女9例,平均年龄(43±9)岁(22~60岁);TRG组18例,男11例,女7例,平均年龄(42±8)岁(19~63岁)。术后1周、1、3个月随访时比较两组Constant-Murley评分、美国肩与肘协会评分系统(ASES)、加州大学肩关节评分系统(UCLA)、患者满意度及术后住院时间。FTS组与TRG组均数比较采用t检验,切口愈合不良发生率比较采用Fisher检验,性别及肩袖损伤分类应用X^2检验。结果术后1周Constant-Murley评分、ASES评分、UCLA评分、患者满意度FTS组均明显高于TRG组(t=2.217,t=2.255,t=2.457,t=2.537,P<0.05),术后1个月Constant-Murley评分、ASES评分、UCLA评分、患者满意度FTS组均明显高于TRG组(t=2.395,t=2.693,t=2.204,t=2.183,P<0.05)。术后住院时间、住院总费用FTS组均低于TRG组(t=2.695,t=2.179,P<0.05);切口愈合不良发生率FTS组与TRG组差异无统计学意义(F=0.717,P>0.05)。FTS术后3个月的Constant-Murley评分、ASES评分UCLA评分及患者满意度与TRG比较无明显差异(t=1.873,t=1.737,t=1.984,t=1.483,P>0.05)。结论快速康复外科理念在关节镜下治疗肩袖损伤中的应用可有效促进术后患者的早期康复,改善肩关节评分,缩短住院时间,提高患者满意度等优点。
Objective To explore the application effect of the notion of fast-track surgery in treating rotator cuff tear under arthroscopy.Methods Thirty-seven patients with rotator cuff tear admitted by joint surgery department of Xianning Central Hospital,from February 2015 to August 2016 were analyzed retrospectively.All the patients were diagnosed with rotator cuff tear alone before operation and underwent rotator cuff suture repair under arthroscopy.These patients were randomly divided into fast-track surgery(FTS)group and traditional rehabilitation group(TRG):19 cases in FTS group(10 males and nine females)with an average age of(43±9)years(22-60 years);18 cases in TRG group(11 males and seven females)with an average age of(42±8)years old(19-63 years).These two groups were compared in terms of Constant score,the rating scale of American Shoulder and Elbow Surgeons(ASES),the University of California at Los Angeles Shoulder Rating Scale(UCLA),patients’satisfaction and length of stay after operation at one week,one month and three months follow-ups,respectively.Results The Constant-Murley score,ASES score,UCLA score and patient’s satisfaction at one week of FTS group were significantly higher than those in the TRG group(t=2.217,t=2.255,t=2.457,t=2.537,P<0.05),The Constant-Murley score,ASES score,UCLA score and patient’s satisfaction at one month of FTS group were significantly higher than those in the TRG group(t=2.395,t=2.693,t=2.204,t=2.183,P<0.05).length of stay after operation,and total hospitalization expense of FTS were greatly lower than those of TRG(t=2.695,t=2.179,P<0.05).There was no statistically significant difference in the occurrence rate of undesirable incision healing between the two groups(F=0.717,P>0.05).The Constant-Murley score,ASES score,UCLA score and patient’s satisfaction at three months after operation of FTS group were much higher than those of TRG group(t=1.873,t=1.737,t=1.984,t=1.483,P<0.05).Conclusion The application of the notion of fast-track surgery in treating rotator cuff tear under arthroscopy can effectively promote patients’early rehabilitation after operation,improve their shoulder joint scores,reduce their hospital stays and enhance their satisfaction.
作者
吴剑
陈俊
刘艳西
胡锋
陈沼飞
赵泉
石振
Wu Jian;Chen Jun;Liu Yanxi;Hu Feng;Chen Zhaofei;Zhao Quan;Shi Zhen(Department of orthopaedics,Xian-ning Central Hospital,The First Affiliated Hospital of Hubei University of Science and Technology,Xianning 437100,China)
出处
《中华关节外科杂志（电子版）》
CAS
2018年第1期96-100,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
康复
关节镜
回旋套
创伤和损伤
Rehabilitation
Arthroscopy
Rotator cuff
Wounds and injuries
作者简介
通信作者:石振,Email:124814778@qq.com
