钙化性冈上肌腱炎的关节外微创清理和治疗.doc

钙化性冈上肌腱炎的关节外微创清理和治疗
【摘要】探讨关节外关节镜下清理治疗保守治疗无效的慢性钙化性冈上肌腱炎的手术方法并评价其疗效。[方法]对18例(男 5例,女13例;年龄34~78岁,平均564岁)患钙化性冈上肌腱炎伴肩部疼痛和活动受限,且保守疗法超过3个月无效的患者行关节镜下手术治疗。关节镜由肩峰下间隙进入,于肩关节外行肩峰下滑囊清理切除并探查和清除冈上肌腱钙化病灶。采用VAS疼痛评分、ConstantMurley评分和X线对患者进行手术前后的评估。[结果]平均随访时间为 9个月(6~15个月),肩部疼痛和功能障碍消失或明显改善,平均VAS疼痛评分术前(78±06)分,术后(17±04)分。平均ConstantMurley评分术前为(61±7)分,术后最后一次复查为(91±4)分。术后X线显示仅2例患者钙化灶有少量残留,但术前症状消失。无需行肩袖修补者。[结论]关节镜下经关节外清除钙化沉积结合滑囊切除对保守治疗无效的慢性钙化性冈上肌腱炎是一种可靠和有效的治疗方法。
【关键词】钙化性肌腱炎肩袖冈上肌腱炎关节镜羟基磷灰石结晶沉积症
Abstract [Objective]To evaluate the surgical technique and effectiveness of extraarticular arthroscopic debridement in patients ent[Methods]Arthroscopic debridement ed in 18 patients (5 males, 13 females; mean age 564, range 34 to 78) in pain and functional disability persisted for more than 3 months despite conservative therapy for rotator cuff calcifying tendinitis Arthroscopy ial interspace and bursectomy inated outside shoulder joint under arthroscopy VAS pain score, ConstantMurley score and plain radiograph ean folloonths (6 to 15 months) Pain and functional disturbance of the shoulder disappeared or obviously improved The average VAS pain score ptoms No case need rotator cuff repair[Conclusion]Extraarticular arthroscopic removal of calcium deposits together y is effective and reliable in patients ent
Key 左右作为穿刺点,11号尖刀沿皮纹方向分别作4 mm皮肤切口,钝性穿刺进入肩峰下滑囊。刨刀清理炎性滑囊,形成肩袖表面软组织腔隙。镜下透过肌腱膜可于肩袖冈上肌腱或