中文摘要：

目的：评价关节镜肩峰下间隙减压术（arthroscopic subacromial decompression,ASD）治疗肩峰下撞击综合征的方法及效果。方法回顾性分析2013年6月至2015年1月应用 ASD 治疗肩峰下撞击综合征患者32例,其中男14例,女18例；年龄31~76岁,平均51.3岁；左肩11例,右肩21例；术前常规拍摄肩关节前后位、冈上肌出口位和腋位 X 线片。19例行 MRI 检查。Ⅰ型肩峰5例,Ⅱ型肩峰12例,Ⅲ型肩峰15例。应用 ASD,32例均行前肩峰成形术,17例同时行关节镜下肩袖缝合术。采用 UCLA 评分标准评价疗效。结果随访时间12~24个月,平均16.4个月。UCLA 评分术前为（16.8±4.1）分,术后（32.4±1.5）分,两者差异有统计学意义（t =-14.107,P〈0.01）。优11例,良18例,可3例,差0例,优良率为90.6%。结论 ASD 治疗肩峰下撞击综合征能达到减压要求,效果满意,且可同时处理关节内其他病变,创伤小,恢复快,应作为治疗肩峰下撞击综合征的首选。

英文摘要：

Background The concept of subacromial impingement syndrome was proposed by Neer through autopsy and clinical research in 1 972,and it is a common cause of pain and dysfunction of the shoulder joint.With the continuous improvement of arthroscopic techniques,the gradual application of shoulder arthroscopy in the treatment of shoulder disorders has been widely approved. This paper aims to retrospectively observe and evaluate the treatment of subacromial impingement syndrome with arthroscopic subacromial decompression （ASD）and its clinical outcome.Methods （1） General information.32 cases were selected in the group from June 2013 to January 201 5.The course of disease ranged from 6 to 48 months and the mean time was 22 months;there were 8 cases with trauma history.All the patients underwent conservative treatment for 3 to 6 months before operation, including rest,physical therapy,oral anti-inflammatory drug therapy and enhanced muscle strength exercises, and the conservative treatment was failed.Imaging examinations X-ray films of anteroposterior view,supraspinatus outlet view and axillary view were performed on routine before operation.According to the acromial classification criteria of Bigliani,5 cases were type I,12 cases were type II and 1 5 cases were type III.Upward migration of humeral head occurred in 9 cases.1 9 cases were examined with MRI and observed the effusion signal below the anterolateral acromion.9 cases showed inhomogeneous signal of rotator cuff,3 cases had partial tear of bursa side and 3 cases＆amp;nbsp;had full-thickness rotator cuff tear.（2 ）Operative method.After general anesthesia,the patient was placed in the beach chair position.After the inspection of glenohumeral joint through posterior portal, intra-articular inflammatory synovial proliferation,articular cartilage stripping and tendon calcification and abrasion were observed and managed with joint debridement and chondroplasty under arthroscopy respectively.Then the subacromial space was examined to find out inflammatory ad