关节镜下打孔“拉花”术治疗钙化性肌腱炎疗效观察

　　【摘要】 目的：探討钙化性肌腱炎关节镜下打孔“拉花”术的临床效果。方法：选取2014年
　　1月-2016年6月本院门诊收治的因钙化性肌腱炎保守治疗效果欠佳患者16例。患者均行关节镜下打孔“拉花”术治疗，术后进行随访，观察治疗效果及术前与末次随访时的Constant-Murley评分及美国加州大学肩关节评分系统（University of California at Los Angels，UCLA）。结果：16例患者平均随访（12.0±7.5）个月，
　　症状均得到改善；术后X-ray显示钙化灶消失15例（93.75%），可见散在钙化灶残留1例（6.25%），但均对术后效果满意，功能良好。末次随访时的Constant-Murley评分、UCLA评分为（91.4±5.8）、（33.2±1.7）分，均高于术前的（41.5±5.6）、（11.5±1.4）分，比较差异均有统计学意义（P<0.05）；其中1例患者术后1年对侧肩出现钙化灶，给予对侧肩行同样手术治疗。结论：经保守治疗无效的钙化性肌腱炎可行关节镜下打孔“拉花”技术，其效果良好，且具有创伤小且安全，不会造成肌腱的副损伤，不必缝合冈上肌等特点。
　　【关键词】 钙化性肌腱炎； 肩袖； 关节镜； “拉花”技术
　　Clinical Observation on Punching Under Arthroscope “Pulling Flower” Treatment of Calcified Tendinitis/SUN Jinghua，RUAN Wenli.//Medical Innovation of China，2018，15（07）：117-120
　　【Abstract】 Objective：To investigate the clinical effect of punching under arthroscope “pulling flower” of calcified tendinitis.Method：A total of 16 calcified tendinitis patients with poor conservative treatment in our hospital from January 2014 to June 2016 were selected.They were treated by punching under arthroscope “pulling flower”，and followed up after operation.The effect of the treatment was observed，the Constant-Murley score and University of California at Los Angels（UCLA） shoulder joint score before and the last follow-up were compared.Result：A total of 16 patients were followed up for an average of（12.0±7.5） months，and all the symptoms improved.The postoperative X-ray showed that calcification disappeared in 15 cases（93.75%），and the residual lesions were found in 1 case（6.25%），but the results were satisfactory and the function was good.At last follow-up，the Constant-Murley score and UCLA score were respectively （91.4±5.8） and （33.2±1.7） points higher than preoperative of （41.5±5.6） and （11.5±1.4） points，the differences were statistically significant（P<0.05），1 patient had calcification on the contralateral shoulder after operation 1 year，and was treated with the same operation on the contralateral shoulder.Conclusion：After ineffective conservative treatment of calcifying tendinitis，patients can be treated with punching under arthroscope “pulling flower” technique，its effect is good，and with less trauma and safety，will not cause injury of tendon，without suture supraspinatus and so on.
　　【Key words】 Calcific tendinitis； Rotator cuff； Arthroscopy； “Pulling flower”technology
　　First-author’s address：The Second People’s Hospital of Dalian，Dalian 116000，China
　　doi：10.3969/j.issn.1674-4985.2018.07.033

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