肩关节镜辅助下TightRope钢板固定治疗肩锁关节脱位疗效及对患者术后免疫应激反应的影响

doi:10.3969/j.issn.1006-6233.2023.11.029

摘要
图/表
参考文献
相关文章 (15)

全文: PDF (1384 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探究肩关节镜辅助下TightRope钢板固定治疗肩锁关节脱位的临床疗效及对患者术后免疫应激反应的影响。方法: 选取2021年2月至2022年2月本院收治的100例肩锁关节脱位患者,根据手术方案分为A组(n=52)和B组(n=48),A组给予肩关节镜辅助下TightRope钢板固定治疗,B组给予肩关节镜辅助下锁骨钩钢板内固定治疗。比较两组临床疗效、肩关节功能[欧洲肩关节协会评分系统Constant肩关节评分]、免疫反应(CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺比值)、应激反应[皮质醇(Cor)、促肾上腺皮质激素(ACTH)]及术后并发症。结果: 相较于B组,A组优良率明显较高(P<0.05),治疗后6个月Constant肩关节各维度评分均明显较高(P<0.05),治疗后1d CD3⁺、CD4⁺、CD8⁺、CD4⁺/CD8⁺比值下降幅度均明显较低(P<0.05),血清Cor、ACTH上升幅度均明显较低(P<0.05),术后并发症总发生率明显较低(P<0.05)。结论: 针对肩锁关节脱位患者而言,肩关节镜辅助下TightRope钢板固定治疗可提高其临床优良率,促进肩关节功能的恢复,减轻对免疫应激反应,术后并发症也较少。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章

关键词 ：关节镜, TightRope钢板, 肩锁关节, 脱位, 免疫反应, 应激反应

Abstract：Objective: To investigate the clinical efficacy of shoulder arthroscopy-assisted TightRope plate fixation in the treatment of acromioclavicular joint dislocation and its effect on postoperative immune stress. Methods: A total of 100 patients with acromioclavicular joint dislocation who were admitted to our hospital from February 2021 to February 2022 were selected and divided into group A (n=52) and group B (n=48) according to the surgical plan.Group A was given shoulder arthroscopy The patients were treated with TightRope plate fixation assisted,and group B was treated with shoulder arthroscopy-assisted clavicle hook plate internal fixation.The clinical efficacy,shoulder joint function [European Shoulder Association scoring system Constant shoulder joint score],immune response (CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺ ratio),stress response [cortisol (Cor),adrenocorticotropic cortex hormone (ACTH)] and postoperative complications] were compared between the two groups. Results: Compared with group B,the excellent and good rate of group A was significantly higher (P<0.05),6 months after treatment,the scores of each dimension of Constant shoulder joint were significantly higher (P<0.05),and the decreasing range of CD3⁺,CD4⁺,CD8⁺,CD4⁺/CD8⁺ ratio at 1 day after treatment was significantly lower (P<0.05).The increase rates of serum Cor and ACTH were significantly lower (P<0.05),and the total incidence of postoperative complications was significantly lower (P<0.05). Conclusion: For patients with acromioclavicular joint dislocation,shoulder arthroscopy-assisted TightRope plate fixation can improve the clinical excellent and good rate,promote the recovery of shoulder joint function,reduce the immune stress response,and reduce postoperative complications.

Key words： Arthroscopy Tightrope plate Acromioclavicular Joint Dislocation Immune response Stress response

基金资助:湖北省自然科学基金,(编号:2019CFB683)

引用本文:

吴斯, 程良礼, 李贺伟, 刘志军, 石峰. 肩关节镜辅助下TightRope钢板固定治疗肩锁关节脱位疗效及对患者术后免疫应激反应的影响[J]. 河北医学, 2023, 29(11): 1905-1910.
WU Si, CHENG Liangli, et al. Clinical Efficacy of Shoulder Arthroscopy-Assisted TightRope Plate Fixation in the Treatment of Acromioclavicular Joint Dislocation and Its Impact on Postoperative Immune Stress Response in Patients. HeBei Med, 2023, 29(11): 1905-1910.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2023.11.029 或 http://www.hbyxzzs.cn/CN/Y2023/V29/I11/1905

[1] 周君,李盛华,宫玉锁,等.微创治疗肩锁关节脱位进展[J].中国中医骨伤科杂志,2018,26(3):84-88.
[2] 蔡亮,吴宇峰,江静华,等.自拟伤科活血汤对肩锁关节脱位患者术后肩功能恢复的影响[J].环球中医药,2018,11(1):145-147.
[3] 白晓东,安明,宋朝晖,等.3种方式治疗RockwoodⅢ型肩锁关节脱位的临床疗效分析[J].中国微创外科杂志,2020,20(12):1093-1099.
[4] Martetschlager F,Kraus N,Scheibel M,et al.The diagnosis and treatment of acute dislocation of the acromioclavicular joint[J].Dtsch Arztebl Int,2019,116(6):89-95.
[5] Zhao Y,Tan L,Tang W,et al.A new coracoclavicular guider for minimally invasive anatomic coracoclavicular reconstruction with two tightRope systems in acute acromioclavicular joint dislocation[J].Sci Rep,2019,9(1):14452.
[6] 胥少汀.实用骨科学[M].北京:人民军医出版,2012.104-109.
[7] 周勇伟,杨骐宁,李晓飞,等.关节镜辅助Tightrope钢板与锁骨钩钢板内固定治疗成人RockwoodⅢ型肩锁关节脱位的疗效比较[J].中华创伤骨科杂志,2019,21(5):446-449.
[8] 王天刚,高义斌,魏艳辉,等.TightRope钢板与锁骨钩钢板内固定术治疗RockwoodⅢ型肩锁关节脱位疗效比较[J].新乡医学院学报,2020,37(4):378-381.
[9] 万磊,刘健,黄传兵,等.类风湿性关节炎患者外周血单个核细胞MALAT1表达降低,hsa-miR155-3p表达增加并参与Notch信号通路调节[J].细胞与分子免疫学杂志,2020,36(6):535-541.
[10] 邓小波,林民贵,胡海波.小切口Tightrope系统在肩锁关节脱位中的疗效及对创伤应激的影响[J].中外医学研究,2021,19(23):14-17.
[11] 王超然,张俊,陈鸿,等.全关节镜下TwinTailTightRope结合远端关节囊修复技术治疗急性肩锁关节脱位[J].中国修复重建外科杂志,2019,33(8):970-975.
[12] Cai L,Wang T,Lu D,et al.Comparison of the tight rope technique and clavicular hook plate for the treatment of Rockwood type Ⅲ acromioclavicular joint dislocation[J].Invest Surg,2018,31(3):226-233.