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中华肩肘外科电子杂志 ›› 2021, Vol. 09 ›› Issue (02) : 148 -153. doi: 10.3877/cma.j.issn.2095-5790.2021.02.008

所属专题: 文献

论著

肩关节运动损伤门诊疾病谱分析
李韬1, 牟可凡1, 熊燕1, 李棋1, 陈刚1, 付维力1, 李箭1, 唐新1,()   
  1. 1. 610041 成都,四川大学华西医院骨科
  • 收稿日期:2020-10-10 出版日期:2021-05-05
  • 通信作者: 唐新
  • 基金资助:
    四川省科技支撑重大项目(2017S20017、2018SZ0237)

Outpatient spectrum analysis of shoulder joint sports injury

Tao Li1, Kefan Mou1, Yan Xiong1, Qi Li1, Gang Chen1, Weili Fu1, Jian Li1, Xin Tang1,()   

  1. 1. Department of Orthopaedics, West China Hospital, Sichuan University, Chengdu 610041, China
  • Received:2020-10-10 Published:2021-05-05
  • Corresponding author: Xin Tang
引用本文:

李韬, 牟可凡, 熊燕, 李棋, 陈刚, 付维力, 李箭, 唐新. 肩关节运动损伤门诊疾病谱分析[J]. 中华肩肘外科电子杂志, 2021, 09(02): 148-153.

Tao Li, Kefan Mou, Yan Xiong, Qi Li, Gang Chen, Weili Fu, Jian Li, Xin Tang. Outpatient spectrum analysis of shoulder joint sports injury[J]. Chinese Journal of Shoulder and Elbow(Electronic Edition), 2021, 09(02): 148-153.

目的

统计近5年本院门诊肩关节运动医学疾病的疾病谱,分析其潜在影响因素,从而为临床诊治提供参考。

方法

收集本院自2014年1月至2018年12月运动医疗团队中所有肩部门诊及病房服务患者相关信息数据,共计纳入患者1 708例。其中同一患者以最终门诊的诊断或手术确诊的主要诊断为准,剔除复查诊断与其他关节的相关数据。采用Excel及SPSS 22.0软件对收集所得资料进行统计分析。

结果

所有患者均由运动医疗团队进行诊断。在纳入的1 708例肩部患者中,平均年龄(50.34±13.76)岁,其中女性占57.55%。纳入患者中肩袖损伤发生率最高,为45.78%;其次为冻结肩(20.67%)和复发性脱位(8.08%);再次为SLAP/肱二头肌腱炎(5.15%)。在所有患者中初次诊断欠准确共计63例,其中最常见的被误诊疾病为冻结肩和肩袖损伤,误诊例数分别为26例(41.27%)和21例(33.33%)。

结论

肩关节疾病已成为日常生活中较为常见的疾病,其中肩袖损伤和冻结肩最为常见;国人的肩痛流行病学可能与国外有明显的差异,如冻结肩比例远远高于西方发达国家人群。但是该结论尚需要大量的多中心流行病学统计分析进行验证。

Background

As one of the most vulnerable parts of human body, shoulder joint disease is the third common musculoskeletal system disease after knee and back-related diseases. With the improvement of quality of life, people pay more attention to shoulder diseases, including frozen shoulder, rotator cuff injury, subacromial impingement syndrome, etc. However, there are few epidemiological studies on shoulder joint diseases in China.

Objective

The disease spectrum of shoulder joint sports medicine diseases in outpatient department of our hospital in recent 5 years was collected and its potential influencing factors were analyzed to provide a reference for clinical diagnosis and treatment.

Methods

From January 2014 to December 2018, a total of 1 708 patients with shoulder joint diseases in the out-patient and in-patient wards of West China Hospital were selected as the research subjects. The ultimate diagnosis of the same patient should be based on outpatient diagnosis or surgical diagnosis. Outpatient review and data related to other joints were excluded. Microsoft Excel and SPSS 22.0 softwares were used for statistical analysis of the collected data.

Results

All patients were diagnosed by the shoulder team of sports medicine. In the included 1 708 shoulder patients, the average age was (50.34±13.76) years, of which women accounted for 57.55%. Among the included patients, the incidence of rotator cuff injury was higher (45.78%) than frozen shoulder (20.67%) , recurrent dislocation (8.08%) and SLAP/biceps tendonitis (5.15%) . In all patients, the initial diagnosis was inaccurate in 63 cases, of which the most common misdiagnosed diseases were frozen shoulder (26/63, 41.27%) and rotator cuff injury (21/63, 33.33%) .

Conclusion

Shoulder joint disease has become a common disease in our daily life, among which rotator cuff injury and frozen shoulder are the most common. The epidemiology of shoulder pain in Chinese may be significantly different from that in foreign countries. For example, the proportion of frozen shoulder is much higher than that in western developed countries. However, it still needs to be verified by a large number of multicentre epidemiological statistical analysis.

表1 常见肩关节损伤类型的年龄、性别、部位的分布特点
类别 例数 性别[例(%)] 年龄(岁,±s 部位[例(%)]
总体 双侧
肩袖损伤 782 304(38.87) 478(61.13) 53.32±14.13 57.23±14.13 55.71±14.16 266(34.02) 504(64.45) 12(1.53)
冻结肩 353 121(34.28) 232(65.72) 51.58±14.10 51.92±14.11 51.80±14.11 177(50.14) 161(45.61) 15(4.25)
复发性脱位 138 112(81.16) 26(18.84) 27.80±14.12 39.30±14.20 29.97±14.12 48(34.78) 89(64.49) 1(0.72)
SLAP损伤/肱二头长头肌腱炎 88 62(73.49) 26(26.51) 35.21±12.25 40.14±13.62 36.63±12.73 31(36.14) 53(59.04) 4(4.82)
颈肩背筋膜炎 48 18(37.50) 30(62.50) 38.72±14.84 38.17±12.58 38.38±12.94 24(50) 19(39.58) 5(10.42)
肩峰下撞击综合征 47 30(63.83) 17(27.17) 42.57±13.78 49.18±5.20 44.96±11.88 8(17.02) 39(82.98) 0(0)
钙化性肌腱炎 43 3(6.98) 40(93.02) 66.67±14.34 53.63±10.40 54.53±14.11 12(27.91) 30(69.77) 1(2.12)
肩峰下滑囊炎 41 20(48.78) 21(51.22) 48.99±14.17 43.43±14.10 41.41±14.10 21(51.22) 19(46.34) 1(2.44)
骨关节炎 15 3(20) 12(80) 49±4.50 60.08±16.38 57.93±15.40 5(33.33) 10(66.67) 0(0)
肩锁关节炎 10 5(50) 5(50) 46±5.97 52.6±5.46 49.3±6.60 2(20) 7(70) 1(10)
肩袖肌腱病 4 3(75) 1(25) 55±3.74 64±0 57.25±5.07 2(50) 2(50) 0(0)
其他 139 44(31.65) 95(68.35) 52.33±13.07 49.92±6.21 50.68±8.92 62(44.60) 74(53.24) 3(2.16)
总体 1 708 725(42.46) 983(57.55) 46.54±15.76 53.14±11.29 50.34±13.76 658(38.20) 1 007(59.52) 43(2.28)
检验值   x2=170.428 t=12.028   x2=82.441  
P   <0.001 <0.001   <0.001  
图1 常见肩关节损伤类型的总体比例分布图
图2 初次诊断欠准确例数分布图
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