肩峰形态和肩袖损伤的相关性研究

向宁

[摘要] 目的 分析研究肩峰形态的变化与肩袖损伤的关系，为临床提供参考及借鉴。方法 方便选取2016年10月—2018年8月该院收治的肩袖损伤患者共52例为实验组，并选择同期该院健康体检者50名为对照组，对所有被检者进行肩峰形态的分型，并测定肩肱间距、肩峰指数、外侧肩峰角、肩峰厚度，使用SPSS统计学软件進行对比分析。 结果 两组被检者肩峰形态对比无明显差异，均以弧形肩峰为主（42.31%、40.00%），差异无统计学意义（χ2=0.511，P>0.05）。实验组与对照组被检者肩肱间距[（7.11±0.98）mm、（8.09±1.01）mm，t=4.974）]、肩峰指数[（0.65±0.06）、（0.61±0.09），t=4.651]、外侧肩峰角[（70.76±5.87）°、（75.97±3.09）°，t=5.576）]、肩峰厚度[（8.11±0.89）mm、（7.19±0.56）mm，t=6.220]有明显差异，差异有统计学意义（P<0.05）;实验组平坦形、弧形、钩形及反弧形中，肩肱间距、肩峰指数、外侧肩峰角、肩峰厚度差异有统计学意义（P<0.05）。 结论 肩袖损伤患者普遍存在肩峰形态的改变，且钩形肩峰形态变化更为明显。

[关键词] 肩峰形态;肩袖损伤;影像学检查;肩袖;关节

[中图分类号] R687.3          [文献标识码] A          [文章编号] 1674-0742（2019）05（a）-0040-03

[Abstract] Objective To analyze the relationship between the change of shoulder shape and rotator cuff injury， and to provide reference for clinical. Methods A total of 52 patients with rotator cuff injuries admitted to our hospital from October 2016 to August 2018 were convenient selected as the experimental group， and 50 healthy subjects in our hospital were selected as the control group. The shoulder shape of all subjects was performed. The classification of the shoulder， the shoulder peak index， the lateral shoulder angle， and the shoulder thickness were measured. SPSS statistical software was used for comparative analysis. Results There was no significant difference in the shape of the shoulders between the two groups（χ2=0.511， P>0.05）. The arcuate shoulders accounted for 42.31% and 40.00%， and the difference was not statistically significant. The shoulder spacing of the experimental group and the control group was [（7.11±0.98）mm， （8.09±1.01）mm， t=4.974]， shoulder peak index was [（0.65±0.06）， （0.61±0.09）， t=4.651]， lateral shoulder angle was [（70.76±5.87）°， （75.97±3.09）°， t=5.576]， shoulder thickness was [（8.11±0.89）mm， （7.19±0.56）mm， t=6.220]. The differences were significantly different（P<0.05）.  The shoulder spacing， shoulder peak index， lateral shoulder angle and shoulder thickness of the patients with curved， hook， flat and anti-arc shape in experimental group， were significantly different（P<0.05）. Conclusion The changes of shoulder shape are common in patients with rotator cuff injury， and the shape of hook-shaped shoulder is more obvious.

[Key words] Shoulder shape; Rotator cuff injury; Imaging examination; Rotator cuff; Joint

肩袖损伤为肩关节损伤的主要类型，其多引起患者出现肩关节疼痛、及关节功能障碍等。肩袖是肩关节的主要肌群主体，包括肩胛下肌、小圆肌、冈上肌、冈下肌[1]。联合孟肱韧带、肩关节囊等，构成鞘状结构，限制肱骨头的运动方向，并维持肩关节的稳定，调节力量[2]。既往临床多认为肩袖损伤是肩峰撞击所引起，但是随着临床深入研究也发现，肩袖损伤的病因并不是单一的撞击理论能够解释清楚[3]。此外还包括缺血缺氧理论、劳损、肩关节的骨性结构异常等。为更好地分析肩峰形态与肩袖损伤的关系，该研究方便选择2016年10月—2018年8月52例肩袖损伤患者进行了以下分析，现报道如下。