肩袖损伤术后再撕裂的危险因素分析

邓明月; 张清; 李一平; 杨金松; 代飞

doi:10.11659/jjssx.09E022070

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肩袖损伤术后再撕裂的危险因素分析

临床研究 | 更新时间：2023-06-13

- 肩袖损伤术后再撕裂的危险因素分析
- Risk factors for re-tearing after rotator cuff injury surgery
- 局解手术学杂志 2023年32卷第6期页码：524-527
- 作者机构：
  
  四川省骨科医院上肢科，四川成都 610041
- 作者简介：
  
  张清，E-mail：zhangqing01@163.com
- 基金信息：
  
  四川省卫健委医学科技项目(21PJ20)
- DOI：10.11659/jjssx.09E022070
  中图分类号： R687.4
- 纸质出版日期：2023-06-25，
  
  收稿日期：2022-09-14，
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邓明月,张清,李一平等.肩袖损伤术后再撕裂的危险因素分析[J].局解手术学杂志,2023,32(06):524-527.

DENG Ming-yue,ZHANG Qing,LI Yi-ping,et al.Risk factors for re-tearing after rotator cuff injury surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(06):524-527.
邓明月,张清,李一平等.肩袖损伤术后再撕裂的危险因素分析[J].局解手术学杂志,2023,32(06):524-527. DOI： 10.11659/jjssx.09E022070.

DENG Ming-yue,ZHANG Qing,LI Yi-ping,et al.Risk factors for re-tearing after rotator cuff injury surgery[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(06):524-527. DOI： 10.11659/jjssx.09E022070.

摘要

目的

分析影响肩袖损伤术后再撕裂的独立危险因素。

方法

选择我院收治的肩袖损伤患者共192例，按照是否发生术后再撕裂分为观察组（67例）和对照组（125例），比较2组患者一般资料、受伤情况及手术情况。采用多因素

Logistic

回归分析肩袖损伤术后再撕裂的独立危险因素，绘制受试者工作特征（

ROC

）曲线评估其预测价值。

结果

2组患者BMI、吸烟、饮酒、合并糖尿病、骨密度等一般资料比较差异具有统计学意义（

0.05）；2组患者撕裂方式、撕裂程度、术前肩关节前屈活动度、肩峰下间隙、肩关节临界角（CSA）等受伤情况比较差异具有统计学意义（

0.05）；2组患者手术缝合技术、手术时间、锚钉类型、缝线磨损、缝线数量等手术情况比较差异具有统计学意义（

0.05）。

Logistic

回归分析显示，合并糖尿病、撕裂

3~5 cm、单排缝合技术、金属锚钉、骨密度≤-2.5 g/cm

是肩袖损伤患者术后再撕裂的独立危险因素，其预测肩袖损伤患者术后再撕裂的曲线下面积（

AUC

）为0.854，临界值为0.467，敏感度、特异度分别为68.66%、91.20%（

=11.636，

0.000 1）。

结论

合并糖尿病、撕裂

3~5 cm、单排缝合技术、金属锚钉、骨密度≤-2.5 g/cm

是肩袖损伤患者术后再撕裂的独立危险因素，对可控危险因素进行有效干预可以降低患者术后再撕裂的发生风险。

Abstract

Objective

To analyze the independent risk factors for re-tearing after rotator cuff injury surgery.

Methods

A total of 192 patients with rotator cuff injury admitted to our hospital were selected and divided into the observation group （67 cases） and the control group （125 cases） according to whether postoperative re-tearing occurred. The general information， injury condition and surgery condition of the patients in the two groups were compared. Multivariate

Logistic

regression was used to analyze the independent risk factors for re-tearing after rotator cuff injury surgery， the

receiver operating characteristic

（

ROC

） curve was drawn to evaluate its predictive value.

Results

There were statistically significant differences in general information such as BMI， smoking， drinking， combined diabetes mellitus and bone mineral density between the two groups （

0.05）. There were statistically significant differences in injury condition such as tearing mode， tearing degree， preoperative anterior flexor motion of shoulder joint， subacromial space and critical shoulder angle （CSA） between the two groups （

0.05）. There were statistically significant differences in surgery condition such as surgical suture technique， surgical time， anchor type， suture wear and suture number between the two groups （

0.05）.

Logistic

regression analysis showed that combined diabetes mellitus， tear

3~5 cm， single-row suture technique， metal anchor， and bone mineral density ≤ -2.5 g/cm

were the independent risk factors for postoperative re-tearing in patients with rotator cuff injury， the

area under the curve

（

AUC

） to predict postoperative re-tearing in patients with rotator cuff injury was 0.854， with the critical value of 0.467， and the sensitivity and specificity were 68.66% and 91.20%， respectively（

=11.636，

0.000 1）.

Conclusion

Combined diabetes mellitus， tear

3~5 cm， single-row suture technique， metal anchor， and bone mineral density ≤ -2.5 g/cm

are the independent risk factors for postoperative re-tearing in patients with rotator cuff injury. Effective intervention based on controllable risk factors can reduce the risk of postoperative re-tearing in patients.

关键词

肩袖损伤术后再撕裂独立危险因素干预对策

Keywords

rotator cuff injurypostoperative re-tearingindependent risk factorintervention strategy

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肩关节镜下不同缝合固定修复技术治疗肩袖损伤的临床疗效