中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (24): 3921-3929.doi: 10.3969/j.issn.2095-4344.0327

• 组织构建循证医学 evidence-based medicine in tissue construction • 上一篇    下一篇

肌腱切断和肌腱固定修复伴肩袖损伤肱二头肌长头腱病变疗效比较的Meta分析

易  刚1,2,杨  静1,2,张  磊1,2,扶世杰1,2,周  鑫1,2,刘  刚1,2,郭晓光1,2,刘  洋1,2,覃  波1,2   

  1. 1西南医科大学附属中医医院骨伤科,四川省泸州市   646000;2泸州市院士工作站,四川省泸州市   646000
  • 收稿日期:2018-05-14
  • 通讯作者: 扶世杰,硕士,教授,主任医师,硕士生导师,西南医科大学附属中医医院骨伤科,四川省泸州市 646000
  • 作者简介:易刚,男,1993年生,四川省泸州市人,汉族,西南医科大学在读硕士,主要从事骨关节疾病的研究。
  • 基金资助:

    四川省教育厅科研计划项目(17ZB0472);泸州市院士工作站在建项目(20180101)

Curative efficacy of tenotomy versus tenodesis for long head of the biceps tendon lesions combined with rotator cuff repair: a Meta-analysis

Yi Gang1, 2, Yang Jing1, 2, Zhang Lei1, 2, Fu Shi-jie1, 2, Zhou Xin1, 2, Liu Gang1, 2, Guo Xiao-guang1, 2, Liu Yang1, 2, Qin Bo1, 2   

  1. 1Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan Province, China; 2Academician Workstation in Luzhou, Luzhou 646000, Sichuan Province, China
  • Received:2018-05-14
  • Contact: Fu Shi-jie, Master, Professor, Chief physician, Master’s supervisor, Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan Province, China; Academician Workstation in Luzhou, Luzhou 646000, Sichuan Province, China
  • About author:Yi Gang, Master candidate, Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan Province, China; Academician Workstation in Luzhou, Luzhou 646000, Sichuan Province, China
  • Supported by:

    the Research Program of Education Department of Sichuan Province, No. 17ZB0472; the Academician Workstation Construction Project of Luzhou, No. 20180101

摘要:

文章快速阅读:
文题释义:
伴肩袖修复的肱二头肌长头肌腱病变:肱二头肌长头肌腱(long head of the biceps brachii tendon,LHBT)起自肩胛骨盂上结节,沿肩峰下间隙从肱骨结节间沟与横韧带形成的骨纤维管道中通过并向下走行,远端止于桡骨转子。主要功能是屈肩、屈肘及前臂旋前位时旋后,加强肱骨头与关节盂的连接,限制肱骨头的上升及移位。LHBT病变将引起肩关节活动功能障碍及疼痛,单纯LHBT损伤相对少见,多数伴有肩关节其他病变,常见的就有肩袖损伤。肩关节的其他病变又会反过来加重LHBT病变。
Meta分析:又称为“荟萃分析”,对具备特定条件的、同课题的诸多研究结果进行综合的一类统计方法。明确简洁地提出需要解决的问题制定检索策略,全面广泛地收集随机对照试验确定纳入和排除标准,剔除不符合要求的文献资料选择和提取,包括原文的结果数据、图表等各试验的质量评估和特征描述统计学处理结果解释、作出结论及评价维护和更新资料。
摘要
背景:
肌腱切断和肌腱固定治疗伴有肩袖修复的肱二头肌长头肌腱病变的疗效比较存在广泛争议。
目的:对肌腱切断和肌腱固定治疗伴肩袖修复的肱二头肌长头肌腱病变的疗效进行Meta分析。
方法:以“肱二头肌,切断,固定,肩袖”为检索词,计算机检索2017年12月之前的中国期刊全文数据库(CNKI)、中文科技期刊全文数据库(VIP)、Medline、PubMed、Cochrane图书馆和Embase并收集所有相关研究,筛选并提取所需数据,使用 Rev Man 5. 3软件进行Meta分析。
结果与结论:共纳入12项研究,共1 076例患者。①Meta分析显示,肱二头肌长头肌腱固定组与肱二头肌长头肌腱切断组相比有更高的Constant评分和更低的Popeye畸形发生率(P < 0.05);②2组术后目测类比评分、ASES评分、UCLA评分、上臂痉挛性疼痛发生率、患者满意度、肩关节活动范围及上臂力量方面差异均无显著性意义(P > 0.05);③结果说明,伴肩袖修复的肱二头肌长头肌腱病变,切断和固定均能有效地减轻疼痛和改善功能,2组在临床功能预后方面无显著差异,肱二头肌长头肌腱固定虽有更高的Constant评分和更低的Popeye畸形发生率,但其临床意义可忽略。

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

关键词: 肱二头肌肌腱, 切断术, 固定术, 肩袖损伤, 疗效, Meta分析, 组织构建, 组织工程

Abstract:

BACKGROUND: There are controversies about the curative efficacy of tenotomy versus tenodesis for long head of the biceps brachii tendon (LHBT) lesions combined with rotator cuff repair.
OBJECTIVE: To evaluate the treatment efficacy of tenotomy versus tenodesis for LHBT lesions combined with rotator cuff repair by a Meta-analysis. 
METHODS: A computer-based search was conducted in CNKI, VIP, Medline, PubMed, Cochrane Library and Embase databases for the related articles published before December 2017. The keywords were “biceps, tenotomy, tenodesis, rotator cuff” in English and Chinese, respectively. The data screen and extraction were performed and then a Meta-analysis was conducted using Revman 5.3 software.
RESULTS AND CONCLUSION: A total of 12 studies were enrolled, involving 1 076 patients. Meta-analysis results showed that the Constant scores in the tenodesis group were significantly higher than those in the tenotomy group (P < 0.05). The incidence of Popeye deformity in the tenodesis group was significantly lower than that in the tenotomy group (P < 0.05). There were no significant differences in the postoperative visual analogue scale scores, American Shoulder and Elbow Surgeons scores and University of California Los Angeles scores, incidence of spasmodic pain of upper arm, patient satisfaction, or the range of motion and power of upper arm between two groups (P > 0.05). In summary, both tenotomy and tenodesis can effectively alleviate pain and improve function in patients with LHBT lesions combined with rotator cuff repair. There is no significant difference in prognosis between two groups. Tenodesis has a higher Constant score and lower risk of Popeye deformity, but has no clinical significance.

中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程
ORCID: 0000-0001-7410-2841(易刚)

Key words: Tenotomy, Tenodesis, Shoulder Joint, Meta-Analysis

中图分类号: