摘要目的 分析关节镜下反向导引过线缝合器在肩袖重建中应用的临床效果。方法 回顾性分析2018年8月至2021年8月赤峰市第二医院收治的57例关节镜下肩袖损伤缝合重建手术患者,其中男25例,女32例;年龄32~82岁,平均(61.7±14.1)岁。按照缝合工具分组,观察组应用反向导引过线缝合器重建,共31例,对照组应用普通肩袖缝合钩,共26例。以使用工具种类、操作步骤、操作方式、操作时间、副损伤、故障率、缝合质量、完成情况为评价指标进行综合评分,比较两组穿刺过线的优良率。采用美国加州大学肩关节评分系统(University of California at Los Angeles,UCLA)评分、美国肩肘外科协会评分(American shoulder and elbow surgeons,ASES)和Constant评分系统进行评分,对比两种工具在肩袖过线缝合的操作效果和术后1年肩关节功能临床疗效评价,应用SPSS 23.0统计软件进行统计分析。结果 本研究患者均获随访,随访时间2~28个月,平均(14.23±8.12)个月。根据操作评价指标,对照组优6例,良14例,差6例,优良率76.92%;观察组优23例,良8例,优良率100%(31/31),两种工具操作评级指标横向比较差异有统计学意义(P<0.001)。两组术后1年的UCLA评分、ASES评分和Constant评分比较,差异有统计学意义(P<0.05)。结论 关节镜下应用反向导引过线缝合器对肩袖过线缝合操作与普通肩袖缝合钩比较具有操作便捷、时间短、缝合强度及缝合质量高、副损伤较小、操作过程中故障率较低等优势,具有较好的临床推广价值。
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