肩袖损伤关节镜修复术后的康复临床研究

关键词：肩袖损伤；康复治疗  美国肩肘医师协会评分  加州大学肩关节评分系统  视觉模拟评分；关节镜

Keywords:rotator cuff injury  rehabilitation  American shoulder elbow scale  University of California at LosAngeles shoulder scale  visual analogue scale  arthroscopy

摘要：

      摘要 目的：分析肩袖损伤关节镜修复术后系统康复的治疗效果。 方法：应用关节镜下修补术治疗肩袖损伤的患者60例。选择术后能够坚持来我院进行系统锻炼的患者为康复组，仅进行出院或门诊指导的患者作为对照组，每组30例，根据国际认可康复流程进行指导。使用美国肩肘医师协会评分（ASES）、加州大学肩关节评分系统（UCLA）和视觉模拟评分（VAS）对患者术前和术后6个月时的肩关节功能进行评价，分别对两组患者术后7周、3个月和6个月时的主动前屈和体侧外旋角度进行测量。 结果：两组患者ASES及UCLA评分术前无明显差异（P>0.05）；术后6个月与术前相比有显著改变（P<0.05），且两项评分康复组均高于对照组（P<0.05）；VAS评分术前无差异（P>0.05），术后较术前均有明显改善（P<0.05）；术后7周、3个月和6个月时肩关节的主动活动度，康复组均高于对照组（P<0.05）。 结论：关节镜下肩袖修补术可以有效治疗肩关节功能障碍，对术后患者进行系统和个体化的康复训练，可以有效恢复患者肩关节的功能，提高治疗效果。

Abstract:

      Abstract Objective：To explore the effectiveness of systematic rehabilitation training on patients with rotator cuff injury after arthroscopic rotator cuff repair. Method：A total of 60 cases with rotator cuff injury treated by arthroscopic rotator cuff repair were included. All the patients were treated with the same rehabilitation protocol, among them 30 cases (treated continually in rehabilitation clinic) were divided into the treatment group, and the other 30 cases （get guidance only） were divided into the control group. Scores of American shoulder elbow scale ASES University of California at LosAngeles (UCLA) shoulder scale and visual analogue scale(VAS) were adopted to evaluate patients' shoulder function before operation and 6 months after operation. The range of motion(ROM) of active forward flexion and external rotation of shoulder were tested at 7 weeks, 3 months and 6 months after operation. Result：There was no significant difference between two groups in ASES,UCLA and VAS scores before operation（P>0.05）; comparing with preoperation, there were significant differences 6 months after operation（P<0.05）, the treatment group had higher scores than the control group in ASES and UCLA scores（P<0.05）but no significant difference in VAS scores. At 7 weeks, 3 months and 6 months after operation, ROM of shoulder in the treatment group were better than that in the control group（P<0.05）. Conclusion：Arthroscopic rotator cuff repair is a successful treatment for rotator cuff injury, and systematic rehabilitation training after operation is an effective way for patients to restore the function of shoulder joint.