摘要
目的研究并探讨关节镜治疗膝关节盘状半月板损伤的临床疗效,并对导致其术后疼痛的影响因素进行分析。方法回顾性分析2013年1月—2016年8月宁夏人民医院骨科收治且随访成功的200例膝关节盘状半月板损伤患者的临床资料。男性86例,女性114例,年龄12~76岁,平均45.24岁。左侧膝关节半月板损伤103例、右侧97例,损伤类型均为圆盘状;损伤分度依据MRI信号进行划分,Ⅰ度32例、Ⅱ度67例、Ⅲ度101例。所有患者均接受关节镜手术治疗,对其治疗效果进行观察,统计术后出现疼痛的病例,并分为疼痛组、无痛组,比较两组患者的Lysholm膝关节功能评分,并对两组患者的各项临床资料进行比较,对导致患者术后疼痛的影响因素进行单因素、多因素Logistics回归分析。结果经关节镜手术治疗后,200例患者的疗效评定结果为优119例、良75例、可4例、差2例,优良率为97.0%。术后56例患者出现膝关节疼痛,疼痛发生率为28.0%。疼痛组患者手术后的Lysholm评分(67.62±12.21)分明显低于无痛组(83.45±13.57)分(P<0.05)。经单因素分析、多因素Logistics回归分析后得出,导致术后疼痛的影响因素主要为患者年龄大、关节软骨损伤、术后过早负重、术后未接受冷敷。结论关节镜治疗膝关节盘状半月板损伤的临床疗效显著,但术后患者容易出现膝关节疼痛,临床上应针对术后疼痛发生的相关因素进行相应的处理。
Objective To study the clinical effect of arthroscopy in the treatment of knee discoid meniscus injury,and to analyze the influencing factors of postoperative pain. Methods The clinical data of 200 patients with knee discoid meniscus injury who underwent orthopedic treatment from Jan. 2013 to Aug. 2016 in Ningxia People＇s Hospital were retrospectively analyzed. There were 86 males and 114 females aged 12 to 76（ mean,45. 24） years,with left knee meniscus injury in 103 cases and right knee meniscus injury in 97 cases,and all meniscus injury types were discoid. Injury degree was based on MRI signal,with Ⅰ degree injury in 32 cases,Ⅱ degree injury in 67 cases and Ⅲ degree injury in 101 cases. All patients underwent arthroscopic treatment. The treatment effect was observed and they were divided into pain group and painless group according to whether there was pain after surgery. The Lysholm knee function score and the clinical data were compared between the two groups,and the factors influencing the postoperative pain were analyzed by single factor and multivariate logistic regression analysis. Results After arthroscopic treatment,the efficacy of the 200 patients were excellent in 119 cases,good in 75 cases,fair in 4 cases and poor in 2 cases,and the excellent rate was 97. 0%. A total of 56 patients after surgery developed knee pain,and the incidence was 28. 0%. The Lysholm score（ 67. 62 ± 12. 21） in the pain group was significantly lower than that in the painless group（ 83. 45 ± 13. 57,P〈0. 05）. The factors influencing postoperative pain were mainly age,articular cartilage injury,premature postoperative weight bearing and no cold compress after operation. Conclusion Clinical efficacy of arthroscopic treatment for knee joint discoid meniscus injury is significant,but postoperative patients are prone to knee pain. Corresponding treatment should be based on related factors.
作者
张小钰
汪玉海
马敬祖
温鹏
ZHANG Xiao-yu WANG Yu-hai MA Jing-zu WEN Peng(Department of Orthopedics, Ningxia People＇s Hospital, Yinchuan 750021, China })
出处
《创伤外科杂志》
2017年第10期766-769,共4页
Journal of Traumatic Surgery
