肩袖损伤患者关节镜修补术后的预后影响因素分析

doi:10.3877/cma.j.issn.2095-5790.2022.01.002

中华肩肘外科电子杂志 ›› 2022, Vol. 10 ›› Issue (01) : 3 -6. doi: 10.3877/cma.j.issn.2095-5790.2022.01.002

论著

肩袖损伤患者关节镜修补术后的预后影响因素分析

张元桢¹, 张艺¹, 薛超¹, 蔡秋晨¹, 程飚¹^,^†(

)

^1. 200072　上海，同济大学附属第十人民医院关节外科

收稿日期:2021-06-23 出版日期:2022-02-05
通信作者: 程飚
基金资助:
国家自然科学基金项目(81972095); 上海市科委项目(19441901702); 上海市科委生物医药科技支撑项目(20S31901400)

Analysis of prognostic factors after arthroscopic rotator cuff repair

Yuanzhen Zhang¹, Yi Zhang¹, Chao Xue¹, Qiuchen Cai¹, Biao Cheng¹^,^†()

^1. Department of Orthopedics, Tenth People's Hospital of Tongji University, Shanghai 200072, China

Received:2021-06-23 Published:2022-02-05
Corresponding author: Biao Cheng

全文 ( ) 下载PDF ( ) 导出引用

目的

分析肩袖损伤的患者在接受肩关节镜下肩袖修补手术治疗的预后影响因素。

方法

回顾性分析2019年2月至2020年2月于同济大学附属第十人民医院关节外科接受肩关节镜下肩袖修补术治疗肩袖损伤的117例患者的基本资料，术后1年随访手术疗效。

结果

预后良好者95例，占81.20%。多因素分析显示，年龄、术前病程、撕裂程度、是否使用富血小板血浆是影响预后的独立因素。

结论

患者年龄、术前病程、肩袖撕裂程度、术中是否使用富血小板血浆是影响肩关节镜手术治疗肩袖损伤预后的重要因素。

关键词: 肩袖损伤, 关节镜修补术, 预后, 影响因素

Background

Rotator cuff injury is the most common clinical shoulder joint disease, accounting for 50%-85% of all shoulder joint diseases. At present, arthroscopic rotator cuff repair has replaced the traditional surgical plan of incision and suture, becoming the first choice of surgeons. Its effectiveness and safety have been recognized in the industry. However, there are also occasional cases with poor postoperative effects and insufficient pain relief.

Objective

To analyze the prognostic factors of arthroscopy rotator cuff repair.

Methods

From February 2019 to February 2020, the primary data of 117 patients who received arthroscopic rotator cuff repair in the department of orthopedics of tenth people's hospital of Tongji university were retrospectively analyzed, and the surgical efficacy was followed up for one year after surgery.

Results

There were 95 patients with a good prognosis, accounting for 81.20%. Multivariate analysis showed that age, preoperative course of the disease, degree of tear, and the use of platelet-rich plasma (PRP) were independent factors affecting prognosis.

Conclusion

The age, preoperative course of the disease, rotator cuff tear degree, use of PRP during operation are important factors affecting the prognosis of arthroscopy rotator cuff repair.

Key words: Rotator cuff injury, Arthroscopic repair, Prognosis, Influencing factors

表1 影响肩关节镜下肩袖修补术后疗效的单因素分析

组别	例数	年龄（<60岁/≥60岁）	性别（男/女）	术前病程（<6个月/≥6个月）	撕裂程度（一般撕裂/巨大撕裂）	使用PRP（是/否）
预后良好组	95	49/46	36/59	59/36	93/2	76/19
预后不良组	22	6/16	7/15	5/17	16/6	12/10
x²值		4.237	0.284	11.178	17.762	6.208
P值		0.033	0.634	0.002	0.010	0.025

表1 影响肩关节镜下肩袖修补术后疗效的单因素分析

组别	例数	年龄（<60岁/≥60岁）	性别（男/女）	术前病程（<6个月/≥6个月）	撕裂程度（一般撕裂/巨大撕裂）	使用PRP（是/否）
预后良好组	95	49/46	36/59	59/36	93/2	76/19
预后不良组	22	6/16	7/15	5/17	16/6	12/10
x²值		4.237	0.284	11.178	17.762	6.208
P值		0.033	0.634	0.002	0.010	0.025

表2 影响肩关节镜下肩袖修补术后疗效的多因素分析

影响因素	B	SE	Wald值	P值	95% CI
年龄	1.328	0.633	4.406	0.036	0.077~0.916
术前病程	1.608	0.618	6.775	0.009	0.060~0.672
撕裂程度	1.737	0.620	7.854	0.005	0.052~0.593
使用PRP	1.261	0.475	7.061	0.008	0.112~0.718

表2 影响肩关节镜下肩袖修补术后疗效的多因素分析

影响因素	B	SE	Wald值	P值	95% CI
年龄	1.328	0.633	4.406	0.036	0.077~0.916
术前病程	1.608	0.618	6.775	0.009	0.060~0.672
撕裂程度	1.737	0.620	7.854	0.005	0.052~0.593
使用PRP	1.261	0.475	7.061	0.008	0.112~0.718

[1]	Tashjian RZ. Epidemiology, natural history, and indications for treatment of rotator cuff tears[J]. Clin Sports Med，2012，31(4):589-604.
[2]	Bakhsh W, Nicandri G. Anatomy and Physical Examination of the Shoulder[J]. Sports Med Arthrosc Rev，2018，26(3):e10-e22.
[3]	Morse K, Davis AD, Afra R, et al. Arthroscopic versus mini-open rotator cuff repair: a comprehensive review and meta-analysis[J]. Arthroscopy J Arthroscopic Rela Surg, 2008, 21(3):1824-1828.
[4]	Teunis T, Lubberts B, Reilly BT, et al. A systematic review and pooled analysis of the prevalence of rotator cuff disease with increasing age[J]. J Shoulder Elbow Surg, 2014,23(12):1913-1921.
[5]	Altintas B, Anderson NL, Pitta R, et al. Repair of rotator cuff tears in the elderly: does it make sense? a systematic review[J]. Am J Sports Med,2020,48(3):744-753.
[6]	Chen X, Jones IA, Park C, et al. The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment[J]. Am J Sports Med,2018,46(8):2020-2032.
[7]	Chen X, Jones IA, Togashi R, et al. Use of platelet-rich plasma for the improvement of pain and function in rotator cuff tears: a systematic review and Meta-analysis with bias assessment[J]. Am J Sports Med,2020,48(8):2028-2041.
[8]	Cofield RH, Parvizi J, Hoffmeyer PJ, et al. Surgical repair of chronic rotator cuff tears. a prospective long-term study[J]. J Bone Joint Surg Am, 2001 ,83(1):71-77.
[9]	Malahias MA, Kostretzis L, Chronopoulos E, et al. Arthroscopic partial repair for massive rotator cuff tears: does it work? a systematic review[J]. Sports Med Open,2019,5(1):13.
[10]	Petrillo S, Longo UG, Papalia R, et al. Reverse shoulder arthroplasty for massive irreparable rotator cuff tears and cuff tear arthropathy: a systematic review[J]. Musculoskelet Surg, 2017 ,101(2):105-112.
[11]	Gutman MJ, Joyce CD, Patel MS, et al. Early repair of traumatic rotator cuff tears improves functional outcomes[J]. J Shoulder Elbow Surg, 2021, 30(11):2475-2483.
[12]	陈垍航，邱斌松，顾海峰,等. 全关节镜下肩袖修补术的预后因素分析[J]. 浙江医学, 2015, 37(21):1780-1782.

[1]	张晓宇, 殷雨来, 张银旭. 阿帕替尼联合新辅助化疗对三阴性乳腺癌的疗效及预后分析[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(06): 346-352.
[2]	许杰, 李亚俊, 韩军伟. 两种入路下腹腔镜根治性全胃切除术治疗超重胃癌的效果比较[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 19-22.
[3]	高杰红, 黎平平, 齐婧, 代引海. ETFA和CD34在乳腺癌中的表达及与临床病理参数和预后的关系研究[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 64-67.
[4]	李代勤, 刘佩杰. 动态增强磁共振评估中晚期低位直肠癌同步放化疗后疗效及预后的价值[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 100-103.
[5]	屈翔宇, 张懿刚, 李浩令, 邱天, 谈燚. USP24及其共表达肿瘤代谢基因在肝细胞癌中的诊断和预后预测作用[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 659-662.
[6]	张超, 张珍, 马梁, 穆欢欢, 刘彩玲. 腹腔镜胰十二指肠切除术术后C级胰瘘患者临床特征及影响因素研究[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 675-678.
[7]	顾雯, 凌守鑫, 唐海利, 甘雪梅. 两种不同手术入路在甲状腺乳头状癌患者开放性根治性术中的应用比较[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 687-690.
[8]	付成旺, 杨大刚, 王榕, 李福堂. 营养与炎症指标在可切除胰腺癌中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2024, 18(06): 704-708.
[9]	李伟, 宋子健, 赖衍成, 周睿, 吴涵, 邓龙昕, 陈锐. 人工智能应用于前列腺癌患者预后预测的研究现状及展望[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 541-546.
[10]	陈樽, 王平, 金华, 周美玲, 李青青, 黄永刚. 肌肉减少症预测结直肠癌术后切口疝发生的应用研究[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(06): 639-644.
[11]	韩加刚, 王振军. 梗阻性左半结肠癌的治疗策略[J/OL]. 中华结直肠疾病电子杂志, 2024, 13(06): 450-458.
[12]	王贝贝, 崔振义, 王静, 王晗妍, 吕红芝, 李秀婷. 老年股骨粗隆间骨折患者术后贫血预测模型的构建与验证[J/OL]. 中华老年骨科与康复电子杂志, 2024, 10(06): 355-362.
[13]	刘郁, 段绍斌, 丁志翔, 史志涛. miR-34a-5p 在结肠癌患者的表达及其与临床特征及预后的相关性研究[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 485-490.
[14]	陈倩倩, 袁晨, 刘基, 尹婷婷. 多层螺旋CT 参数、癌胚抗原、错配修复基因及病理指标对结直肠癌预后的影响[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(06): 507-511.
[15]	王景明, 王磊, 许小多, 邢文强, 张兆岩, 黄伟敏. 腰椎椎旁肌的研究进展[J/OL]. 中华临床医师杂志(电子版), 2024, 18(09): 846-852.

阅读次数

全文

摘要

选择文件类型/文献管理软件名称

选择包含的内容

Analysis of prognostic factors after arthroscopic rotator cuff repair

模态框（Modal）标题

选择文件类型/文献管理软件名称

选择包含的内容

Analysis of prognostic factors after arthroscopic rotator cuff repair