摘要
[目的]比较止血带及无止血带下行关节镜下多韧带重建治疗KD-Ⅲ-M型膝关节脱位的临床疗效。[方法]选取2017年1月~2022年1月收治的27例膝关节脱位合并多韧带损伤的患者,采用随机数字表法分为两组。止血带组13例全程于止血带下行手术;无止血带组14例,全程于无止血带下手术。比较两组围手术期资料及随访结果。[结果]两组患者均顺利完成手术,两组手术时间、术中失血量、术后首次下床时间、术后住院天数的差异均无统计学意义(P>0.05),无止血带组的术后引流量显著少于止血带组[(35.6±2.7)ml vs(72.2±3.3)ml,P<0.001]。术后随时间推移,两组VAS评分显著减少(P<0.05),Lysholm和IKDC评分显著增加(P<0.05)。术后1周,无止血带组的VAS评分显著少于止血带组[(4.4±0.8)vs(5.6±0.9),P=0.021],其他相应时间点,两组VAS评分的差异均无统计学意义(P>0.05)。相应时间点,两组Lysholm和IKDC评分的差异均无统计学意义(P>0.05)。[结论]关节镜下多韧带重建治疗KD-Ⅲ-M型膝关节脱位疗效满意,而无非止血带下行该手术具有引流少及早期疼痛较轻等优势。
[Objective]To compare the clinical effect of multi-ligament reconstruction and repair with or without tourniquet for KD-Ⅲ-M knee dislocation.[Methods]A total of 27 patients with knee joint dislocation combined with multiple-ligament injuries admittedfrom January 2017 to January 2022 were randomly divided into two groups using a random number table.In the tourniquet group,13 pa-tients received multi-ligament reconstruction and repair underwent tourniquet,while in the non-tourniquet group,14 cases were operatedon without tourniquet.The perioperative data and follow-up results were compared between the two groups.[Results]All patients in bothgroups were operated successfully without significant differences in terms of operation time,intraoperative blood loss,ambulation time aftersurgery,postoperative hospitalization days between the two groups(P<0.05).However,the non-tourniquet group had significantly lowerpostoperative drainage volume than the tourniquet group[(35.6±2.7)ml vs(72.2±3.3)ml,P<0001].The VAS scores significantly decrease,whereas the Lysholm and IKDC scores significantly increased in both groups over time postoperatively(P<0.05).The non-tourniquet groupproved significantly superior to the tourniquet group in VAS score 1week after surgery[(4.4±0.8)vs(5.6±0.9),P=0.021],despite of the factthat it became not significant between the two groups latterly(P>0.05).There were no statistically significant differences in Lysholm and IK-DC scores between the two groups at any corresponding time points(P>0.05).[Conclusion]The multi-ligament reconstruction and repairfor KD-Ⅲ-M dislocation of the knee achieve satisfactory clinical consequences,while the non-tourniquet operation has the advantages ofless drainage and less early pain.
作者
郭徽灵
颜来鹏
李书林
胡世平
汤发强
GUO Hui-ling;YAN Laipeng;LI Shu-lin;HU Shi-ping;TANG Fa-qiang(Department of Orthopedics,Fujian Provincial Hospital,Fujian Medical University,Fuzhou 350001,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2024年第6期565-569,共5页
Orthopedic Journal of China
关键词
膝关节脱位
止血带
关节镜
多韧带重建
knee dislocation
tourniquet
arthroscopy
multi-ligament reconstruction
