经皮Yurt-bone缝合与开放微创手术治疗急性跟腱断裂的比较研究

发布时间：2018-06-05 20:49

本文选题：跟腱断裂 + 力学生物学　；参考：《新疆医科大学》2017年硕士论文

【摘要】：目的:比较经皮Yurt-bone缝合与开放微创手术治疗急性闭合性跟腱断裂的临床疗效。方法:回顾性分析2011年9月至2015年12月间我科收治的31例急性闭合性跟腱断裂患者,根据手术方法不同分为经皮组(经皮Yurt-bone缝合技术治疗,14例)和开放微创组(开放微创手术治疗,17例)。比较两组患者住院时间、术中出血量、手术时间、切口延期愈合率、腓肠神经损伤率、小腿最大周径减少值、单足提踵试验阳性率、再次断裂率及末次随访时的ATRS功能评分,附加分析彩色超声多普勒、CT三维重建等影像学检查结果。结果:所有患者术后获得平均17.6个月(9~27个月)的随访。经皮组的住院时间、术中出血量及手术时间分别为[(4.2±0.8)d、(8.5±3.6)mL、(41.4±5.3)min],均少于开放微创组的[(5.8±1.3)d、(43.5±7.6)mL、(75.5±7.8)min]差异有统计学意义(P0.05)。经皮组和开放微创组患者小腿最大周径减少值分别为(1.9±0.2)cm和(2.0±0.2)cm,切口延期愈合率分别为0和11.8%,单足提踵试验阳性率分别为7.1%和5.9%,腓肠神经损伤率分别为7.1%和0,ATRS评分分别为(91.2±3.7)分和(90.4±3.3)分,以上指标两组间比较无统计学意义(P0.05)。两组所有患者未发生跟腱再断裂。结论:经皮Yurt-bone重建方法与微创手术相比具有住院时间短、手术时间短、术中出血量少等优势,未增加相关并发症,可早期功能锻炼,适合临床推广。
[Abstract]:Objective: to compare the clinical efficacy of percutaneous Yurt-bone suture and open minimally invasive surgery in the treatment of acute closed Achilles tendon rupture. Methods: from September 2011 to December 2015, 31 patients with acute closed rupture of Achilles tendon were retrospectively analyzed. According to the different surgical methods, the patients were divided into percutaneous group (14 cases treated by percutaneous Yurt-bone suture) and open minimally invasive group (17 cases treated with open minimally invasive surgery). The duration of hospitalization, intraoperative bleeding, operative time, delayed healing rate of incision, injury rate of sural nerve, maximum circumference of calf, positive rate of one-foot heel test, rerupture rate and ATRS function score at the last follow-up were compared between the two groups. The results of three-dimensional CT reconstruction with color Doppler ultrasound were also analyzed. Results: all patients were followed up for an average of 17.6 months (9 ~ 27 months). The hospitalization time, intraoperative bleeding volume and operative time in the percutaneous group were (4.2 卤0.8d) and 8.5 卤3.6m / L (41.4 卤5.3)min), respectively, which were significantly lower than those in the open minimally invasive group (43.5 卤7.6mL, 75.5 卤7.8)min). In the percutaneous group and open minimally invasive group, the maximum circumference reduction of the leg was 1.9 卤0.2)cm and 2.0 卤0.2 cm, respectively, the delayed healing rate of incision was 0 and 11.8, the positive rate of one-foot heel test was 7.1% and 5.9%, and the injury rate of sural nerve was 7.1% and 0% respectively. The scores were 91.2 卤3.7 and 90.4 卤3.3, respectively. There was no significant difference between the above two groups (P 0.05). No rupture of Achilles tendon occurred in all patients in both groups. Conclusion: compared with minimally invasive surgery, percutaneous Yurt-bone reconstruction has advantages of shorter hospitalization time, shorter operation time, less intraoperative bleeding, no increase of related complications, and early functional exercise, which is suitable for clinical application.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.2

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