摘要
目的介绍腱缝合后鞘内置入法,局部注射透明质酸钠防止Ⅱ区屈肌腱粘连的方法和疗效。方法按此法治疗Ⅱ区屈肌腱损伤33例43指。屈曲型26例25指,在肌腱远断端以远0.5cm另作腱鞘切口,缝合肌腱。伸直型7例8指经原腱鞘切口缝合肌腱。缝合肌腱均用Tsuge法术后肌腱置入健康腱鞘内,鞘内注射透明质酸钠0.5～1.0ml。结果术后随访5个月～一年7个月,按TAM评定标准评定疗效,屈曲型35指,优22指,良9指,中3指,差1指,优良率88.57%。伸直型8指,优3指,良2指,中2指,差1指,优量率62.5%,总优量率83.7%。结论该术式对屈肌腱损伤疗效满意,可能与肌腱缝合口被健康腱鞘包容有关,透明质酸钠具有促进肌腱愈合,防止或减轻术后粘连的作用。
Objective To introduce a surgical procedure an d observe the effect of sodium hyalur onate product(SHP)on prevention of flexor tendon adhesion in zoneⅡ.Methods Flexor tendon injuries were divided into the extension type and the flexion bype.The flexion ten dons of the extension type were repaired via the original cut on the sheath,the suture site of the tendon slided into the proximal i ntact part of the sheath 0.5cm distal to distal tendon stump,and the tendon was repaired via the incision,The suture site was then placed in the intact sheath canal between the two cuts.0.5～1.0ml SHP was injected into the tendon sheath in the operation of primary tendon repair of 43flexor te ndon in 33cases.Among which 7were ex tension type and 26were flexion type.Results43tendons of 33cases were followed u p for an average of 10months,accordi ng to TAM standard,the excellent or good rate was 83.7%.Conclusion lntrasheath embeding of the suture s ite is an optimal surgical procedure in flexor tendon in zoneⅡ,SHP could effectively promote tendon healing and prevent or reduce tend on adhesion.[
关键词
腱损伤
缝合技术
透明质酸
防治
屈肌腱粘连
Tendon injuries Suture technique Hy aluronate acid Treatment outcome
