摘要
背景:目前,临床多通过手术方式治疗膝关节创伤后僵直(posttraumatic knee stiffness,PTKS)。而传统膝关节松解术在治疗PTKS中存在用时长、创伤大、出血多、易复发等缺点。目的:探讨小切口膝关节松解术对膝关节创伤后僵直患者疼痛程度、手术时长及近期疗效的影响。方法:选择2016年6月至2017年4月在我院接受治疗的164例PTKS患者。按随机数字表法将其分为对照组与观察组,每组各82例。对照组给予传统膝关节松解术治疗,观察组给予小切口膝关节松解术治疗。术后两组患者均接受康复干预;观察两组手术时长、切口长度、术中出血量,并比较两组患者手术前后疼痛程度、膝关节活动度、膝关节功能、生活质量。结果:与对照组相比,观察组的手术时长、切口长度、术中出血量均下降,差异具有统计学意义(P<0.01)。与术前相比,术后两组患者的VAS评分均下降,而膝关节活动度、Lysholm评分及SF-36评分均升高,差异具有统计学意义(P<0.01)。同时,术后观察组的VAS评分显著低于对照组,而膝关节活动度、Lysholm评分及SF-36评分显著高于对照组,差异具有统计学意义(P<0.01)。观察组和对照组的临床总有效率分别为92.68%和79.27%,差异具有统计学意义(P<0.05)。结论:小切口膝关节松解术能够有效缩短膝关节创伤后僵直的手术时长,并缓解疼痛程度,近期临床疗效显著。
Background：At present,surgical treatment is the most common method for posttraumatic knee stiffness （PTKS）.However,traditional knee joint loosening has many disadvantages,such as long surgical duration,large trauma,much bleeding and easy recurrence in the treatment of PTKS.Objective：To explore the influence of small incision knee joint lysis on degree of pain,length of operation and short-term clinical outcomes in PTKS patients.Methods：A total of 164 PTKS patients treated in our hospital from June 2016 to April 2017 were enrolled in this study.They were divided into control group and observation group according to the random number table.There were 82 patients in each group.Traditional and small-incision knee joint lysis were given respectively,in the two groups.All patients were given rehabilitation intervention after operation.Operation time,incision length and intraoperative blood loss were observed.Meanwhile,the degree of pain,knee mobility,knee function,and quality of life were compared between two groups.Results：Compared with those in the control group,operation time,incision length and intraoperative blood loss in the observation group were decreased significantly （P〈0.01）.Compared with those before operation,VAS score decreased significantly after operation,while knee mobility,Lysholm score and SF-36 scores increased in both groups （P〈0.01）.Postoperative VAS score in the observation group was significantly lower than that in the control group （P〈0.01）,while postoperative knee mobility.Lysholm score and SF-36 score in the observation group was significantly higher than those in the control group （P〈0.01）.Total effective rate of the observation group was significantly higher than that of the control group （92.68% vs 79.27%,P〈0.05）.Conclusions：Small incision knee joint lysis can effectively shorten operation time,alleviate degree of pain and have a remarkable shortterm efficacy for knee joint stiffness after trauma.
出处
《中华骨与关节外科杂志》
2017年第4期294-297,共4页
Chinese Journal of Bone and Joint Surgery
