肱二头肌长头肌腱病变与肩袖损伤的相关性及临床意义分析

doi:10.13418/j.issn.1001-165x.2019.02.016

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (2): 196-200.doi: 10.13418/j.issn.1001-165x.2019.02.016

肱二头肌长头肌腱病变与肩袖损伤的相关性及临床意义分析

易刚^{1, 2}，　张磊^{1, 2}，　杨静³，　郭晓光^{1, 2}，　刘洋^{1, 2}，　覃波^{1, 2}，　汪国友^{1, 2}，　扶世杰^{1, 2}

1. 西南医科大学附属中医医院骨伤科；　2. 泸州市院士工作站；
3. 西南医科大学附属中医医院妇产科，四川泸州 646000

收稿日期:2018-09-10 出版日期:2019-03-25 发布日期:2019-04-29
通讯作者: 扶世杰，主任医师，硕士生导师，Tel：13882759783，E-mail：fushijieggj@126.com
作者简介:易刚(1993-)，男，四川泸州人，在读硕士，Tel：18715748879，E-mail：yi_gang1001@163.com
基金资助:
四川省中医药管理局中医药科研专项(2018YY003)；泸州市院士工作站在建项目(20180101)；泸州市人民政府-西南医科大学科技战略合作项目(2016LZXNYD-J08)；西南医科大学创新创业训练计划项目（2018193）

Clinical significance and relationship between the long head of bicep tendon lesions and rotator cuff injury

YI Gang ^{1, 2}, ZHANG Lei^{1, 2}, YANG Jing³, GUO Xiao-guang ^{1, 2}, LIU Yang ^{1, 2}, QIN Bo ^{1, 2}, WANG Guo-you^{1, 2}, FU Shi-jie ^{1, 2}

1.Department of Orthopedics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University; 2.Academician Workstation in Luzhou; 3.Gynaecology and Obstetrics, the Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University, Luzhou 646000, Sichuan Province, China

Received:2018-09-10 Online:2019-03-25 Published:2019-04-29

摘要/Abstract

摘要：

目的分析肱二头肌长头肌腱（long head of the biceps brachii tendon，LHBT）病变与肩袖损伤的相关性及临床意义。方法　分析2010~2017年间西南医科大学附属中医医院经关节镜修复的126例肩袖损伤患者，术中对LHBT进行检查和评价，记录LHBT病变种类，分析LHBT病变与肩袖撕裂时间、撕裂大小和累及肌腱的相关性。结果　发现LHBT I型病变（肌腱炎）51例（40.5%），II型病变（半脱位）12例（9.5%），III型病变（全脱位）12例（9.5%），IV型病变（部分撕裂）15例（11.9%），V型病变（完全撕裂）6例（4.8%），30例（23.8%）无明显LHBT病理改变；病史超过12周的慢性肩袖撕裂患者均伴有LHBT病变；伴肩胛下肌（subscapularis，SSC）撕裂的肩袖损伤患者更易出现LHBT病变，且SSC撕裂程度越大，LHBT病变发生率越高，差异有统计学意义（P<0.05）。结论 LHBT病变与肩袖损伤特别是合并SSC撕裂者密切相关，LHBT病变与SSC撕裂程度呈正相关；检查肩袖损伤的病例时，应注意LHBT的情况，避免漏诊；肩袖损伤的早期识别与修复可防止LHBT病变进一步恶化。

关键词: 肱二头肌长头肌腱病变, 　肩袖损伤, 　肩胛下肌, 　相关性

Abstract:

Objective　To analyze clinical significance and relationship between the long head of bicep tendon (LHBT) lesions and rotator cuff injury.　Methods　A total of 126 patients with rotator cuff repaired by arthroscopy were analyzed in the Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University during 2010~2017. Examination and evaluation of LHBT were performed during the operation. The types of LHBT lesions were recorded and the correlation between the LHBT lesion and the time of rotator cuff tear, the size of the tear and the involvement of the tendon were analyzed. Results There were type I lesions of LHBT (tendinitis) 51 cases (40.5%), type II lesion (subluxation) 12 cases (9.5%), type III (total dislocation) 12 cases (9.5%), type IV (partial tear) 15 cases (11.9%), type V (complete rupture) 6 cases (4.8%), remaining 30 cases (23.8%) without obvious pathological changes of LHBT. All patients with chronic rotator cuff tear who had a history of more than 12 weeks were accompanied by LHBT lesions. The patients with the subscapalaris (SSC) injury were more prone to LHBT lesions. And the greater the degree of the tearing of the subscapalaris, the higher the incidence of LHBT lesions；the difference was statistically significant (P<0.05).　Conclusions　The LHBT lesion was closely related to the rotator cuff injury, especially in patients with the tearing of the SSC, which was positively correlated with the size of the tearing of the SSC. When examining rotator cuff injury, especially in the case of combined injury of the SSC, we should pay attention to LHBT to avoid missed diagnosis. Early identification and repair of injured rotator cuff can prevent further deterioration of LHBT lesions.

Key words: The long head of bicep tendon lesion, 　Rotator cuff injury, 　Subscapularis, 　Relationship

易刚,张磊,杨静,郭晓光,刘洋,覃波,汪国友,扶世杰. 肱二头肌长头肌腱病变与肩袖损伤的相关性及临床意义分析[J]. 中国临床解剖学杂志, 2019, 37(2): 196-200.

YI Gang, ZHANG Lei, YANG Jing, GUO Xiao-guang, LIU Yang, QIN Bo, WANG Guo-you, FU Shi-jie. Clinical significance and relationship between the long head of bicep tendon lesions and rotator cuff injury[J]. Chinese Journal Of Clinical Anatomy, 2019, 37(2): 196-200.

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肱二头肌长头肌腱病变与肩袖损伤的相关性及临床意义分析

Clinical significance and relationship between the long head of bicep tendon lesions and rotator cuff injury

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