肩关节钙化性肌腱炎急性期手术与非手术的疗效比较

Comparison of surgical and non-surgical treatment for calcifying tendinitis of the shoulder in acute stage

关键词:  关节痛  钙化性肌腱炎  微创  肩关节

Key words:  arthralgia  calcified tendinitis  minimally invasive  shoulder joint

摘要:

目的 比较肩关节钙化性肌腱炎急性期手术治疗与非手术治疗的效果。方法 回顾分析同济大学附属东方医院自2012年3月—2021年6月门诊或住院处置的33例肩关节钙化性肌腱炎急性期患者（女21例，男12例）。随机分成手术组与非手术治疗组（口服药物治疗组），手术组15例记录术前、术后疼痛视觉模拟评分（visual analogue scale, VAS评分），肩关节病例行肩关节功能评分（American Shoulder and Elbow Surgeon’s Form, ASES）；非手术组18例记录就诊当天、治疗后的VAS评分，对两组进行ASES评分。结果 两组VAS评分术前（8.68±0.48）分，就诊当天（8.38±0.50）分；术后第1天为（3.85±0.31）分，治疗后第1天（6.68±0.82）分；术后2周为（2.06±0.21）分，治疗后第2周（3.98±1.21）分。ASES评分术前（19.03±2.17）分，就诊当天（21.75±4.95）分；术后2周为（85.78±3.00）分，治疗后第2周（81.15±2.46）分，两组治疗后两周的VAS评分及ASES评分均较治疗前明显改善，而手术组改善更明显。结论 钙化性肌腱炎急性期患者发病有性别差异，微创手术治疗恢复更快。

Abstract:

Objective To compare the effects of surgical treatment and non-surgical treatment for calcifying tendinitis of the shoulder joint in acute stage. Methods Thirty three patients with calcifying tendinitis of the shoulder in the acute stage admitted to Shanghai Oriental Hospital from March 2012 to June 2021A were randomly divided into surgical(n=15) and non-surgical treatment(n=18) groups. The pain visual analogue scale(VAS), and the American Shoulder and Elbow Surgeon’s Form(ASES) of shoulder joint were assessed before and after treatment, and compared between two groups. Results The VAS scores of the two groups were 8.68±0.48 and 8.38±0.50 before treatment(P>0.05). The VAS scores were 3.85±0.31 and 6.68±0.82 at d1 after treatment, 2.06±0.21 and 3.98±1.21 at second week after operation in two groups. The average ASES scores were 19.03±2.17 and 21.75±4.95 before treatment in two groups(P>0.05). The ASES scores were 85.78±3.00 and 81.15±2.46 at the second week after treatment. The VAS score and ASES score of the two groups were significantly improved after treatment(P<0.001), while the improvement was more significantly in the surgical group at the second week after treatment(P<0.001). Conclusion Compared to non-surgical treatment the surgical treatment is more effective for patients with calcifying tendinitis of the shoulder in the acute stage.