發(fā)布時間：2018-12-26 18:03

【摘要】：目的:比較關(guān)節(jié)鏡肩袖修補術(shù)后快速康復(fù)與延遲康復(fù)的療效與安全性。方法:計算機系統(tǒng)檢索Pubmed、EMBASE、Cochrane library、中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫(CBM)、中國知網(wǎng)(CNKI)、萬方數(shù)據(jù)庫、維普數(shù)據(jù)庫等,及手工查找關(guān)于比較關(guān)節(jié)鏡肩袖修補術(shù)后快速康復(fù)與延遲康復(fù)臨床結(jié)果的隨機對照研究。按照文獻納入標(biāo)準(zhǔn)、排除標(biāo)準(zhǔn)選取文獻,并提取相關(guān)數(shù)據(jù),評價研究方法學(xué)質(zhì)量,采用Review Manager5.3軟件對提取的數(shù)據(jù)進行統(tǒng)計學(xué)分析。結(jié)果:共納入文獻7篇,均為隨機對照研究,包括547名患者,其中快速康復(fù)組279名,延遲康復(fù)組268名。Meta分析結(jié)果顯示:快速康復(fù)組術(shù)后6個月肩關(guān)節(jié)前屈活動角度[MD=4.90,95%CI(1.98,7.82),P=0.001]大于延遲康復(fù)組,兩組在術(shù)后6個月肩關(guān)節(jié)外旋活動度、ASES評分、Constant評分、VAS評分及術(shù)后12個月肩關(guān)節(jié)前屈活動度、外旋活動度、ASES評分、Constant評分、VAS評分等方面差異無統(tǒng)計學(xué)意義(P0.05)。在肩袖愈合方面,兩康復(fù)組肩袖中小全層撕裂與中大全層撕裂修補術(shù)后肩袖愈合率及再撕裂率差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:關(guān)節(jié)鏡肩袖修補術(shù)后快速康復(fù)能促進早期肩關(guān)節(jié)前屈活動度恢復(fù),但并不能明顯促進肩關(guān)節(jié)功能恢復(fù),而兩組術(shù)后無論是中小撕裂還是中大撕裂,肩袖愈合率及再撕裂率沒有顯著差異。
[Abstract]:Objective: to compare the efficacy and safety of rapid and delayed rehabilitation after arthroscopic rotator cuff repair. Methods: Pubmed,EMBASE,Cochrane library, Chinese biomedical literature database, (CBM), (CNKI), Wanfang database, Weip database, etc., were searched by computer system. A randomized controlled study was conducted to compare the clinical results of rapid and delayed rehabilitation after arthroscopic rotator cuff repair. According to the standard of literature inclusion, the exclusion criteria were selected, and the relevant data were extracted, the quality of the research methodology was evaluated, and the extracted data were analyzed statistically by Review Manager5.3 software. Results: a total of 7 articles were included, all of which were randomized controlled trials, including 547 patients, among whom 279 were in the rapid rehabilitation group. The results of Meta analysis showed that the angle of shoulder flexion activity [MD=4.90,95%CI (1.98 鹵7.82), P0. 001] in the rapid rehabilitation group was higher than that in the delayed rehabilitation group at 6 months after operation. There was no significant difference between the two groups in terms of shoulder pronation activity, ASES score, Constant score, VAS score and 12 months postoperation shoulder flexion activity, external rotation activity, ASES score, Constant score, VAS score and so on (P0.05). In the area of rotator cuff healing, there was no significant difference in the healing rate and retearing rate of rotator cuff between the two groups (P0.05). Conclusion: the rapid recovery after arthroscopic rotator cuff repair can promote the recovery of early shoulder flexion, but it can not obviously promote the recovery of shoulder function. There was no significant difference in rotator cuff healing rate and retearing rate.
【作者單位】： 安徽醫(yī)科大學(xué)第一附屬醫(yī)院運動創(chuàng)傷與關(guān)節(jié)鏡外科;
【分類號】：R687.4

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