肩峰形態和肩袖損傷的相關性研究

向寧

[摘要] 目的 分析研究肩峰形態的變化與肩袖損傷的關系，為臨床提供參考及借鑒。方法 方便選取2016年10月—2018年8月該院收治的肩袖損傷患者共52例為實驗組，并選擇同期該院健康體檢者50名為對照組，對所有被檢者進行肩峰形態的分型，并測定肩肱間距、肩峰指數、外側肩峰角、肩峰厚度，使用SPSS統計學軟件進行對比分析。 結果 兩組被檢者肩峰形態對比無明顯差異，均以弧形肩峰為主（42.31%、40.00%），差異無統計學意義（χ2=0.511，P>0.05）。實驗組與對照組被檢者肩肱間距[（7.11±0.98）mm、（8.09±1.01）mm，t=4.974）]、肩峰指數[（0.65±0.06）、（0.61±0.09），t=4.651]、外側肩峰角[（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]有明顯差異，差異有統計學意義（P<0.05）;實驗組平坦形、弧形、鉤形及反弧形中，肩肱間距、肩峰指數、外側肩峰角、肩峰厚度差異有統計學意義（P<0.05）。 結論 肩袖損傷患者普遍存在肩峰形態的改變，且鉤形肩峰形態變化更為明顯。

[關鍵詞] 肩峰形態;肩袖損傷;影像學檢查;肩袖;關節

[中圖分類號] R687.3? ? ? ? ? [文獻標識碼] A? ? ? ? ? [文章編號] 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

肩袖損傷為肩關節損傷的主要類型，其多引起患者出現肩關節疼痛、及關節功能障礙等。肩袖是肩關節的主要肌群主體，包括肩胛下肌、小圓肌、岡上肌、岡下肌[1]。聯合孟肱韌帶、肩關節囊等，構成鞘狀結構，限制肱骨頭的運動方向，并維持肩關節的穩定，調節力量[2]。既往臨床多認為肩袖損傷是肩峰撞擊所引起，但是隨著臨床深入研究也發現，肩袖損傷的病因并不是單一的撞擊理論能夠解釋清楚[3]。此外還包括缺血缺氧理論、勞損、肩關節的骨性結構異常等。為更好地分析肩峰形態與肩袖損傷的關系，該研究方便選擇2016年10月—2018年8月52例肩袖損傷患者進行了以下分析，現報道如下。