关节镜下Fast-Fix全内缝合法治疗半月板损伤与病程相关性观察

发布时间：2018-06-03 20:20

  本文选题：Fast-Fix + 半月板损伤　； 参考：《成都中医药大学》2015年硕士论文

【摘要】：目的：本课题旨在通过对进行了关节镜下Fast-Fix半月板缝合患者临床资料的收集,分析病程与半月板缝合术后临床疗效之间的相关性,为临床治疗提供依据。方法：选取2011-2013年期间在四川省中医医院骨科住院并符合纳入标准的76例患者(81例膝),收集患者一般资料：病程、性别、年龄、损伤部位、损伤形态。根据病程长短以Keene时间划分标准[1],将患者按病程分为三组：A、B、C组。A组：急性期32例；B组：亚急性期25例；C组：慢性期19例。各组术前均行膝关节MRI检查评估半月板损伤情况,并行关节镜检十半月板缝合术。术前及术后3、6、12月随访时均进行疼痛视觉模拟评分法(visual analogue scale,简称VAS)评分、膝关节功能Lysholm评分,术后随访时进行半月板临床愈合情况Barrett标准[2]的评估。根据结果分析病程与半月板缝合术后临床疗效之间的相关性。结果：76例病人都进行了完整随访。结果显示各组术前及术后疼痛VAS评分差异均有统计学意义(P0.05),术前与术后膝关节功能Lysholm评分差异均有统计学意义(P0.05),根据Barrett标准,A组临床愈合率为96.88%,B组临床愈合率为92.00%,C组临床愈合率为89.47%,关节镜下Fast-Fix全内缝合法治疗半月板损伤总体临床愈合率为93.42%。A、B、C三组之间术后3、6、12月疼痛VAS评分差异均无统计学意义(P0.05)；A、B、C三组之间术后3月膝关节功能Lysholm评分差异有统计学意义(P0.05),但术后6、12月膝关节功能Lysholm评分差异均无统计学意义(P0.05)；A、B、C三组术后3、6、12月半月板临床愈合率差异均无统计学意义(P0.05)。结论：关节镜下Fast-Fix全内缝合法是治疗半月板损伤的一种有效方法,总体临床愈合率为93.42%。早期缝合有利于膝关节功能更快恢复,但病程长短对半月板缝合术后远期临床疗效没有明显影响。建议Ⅲ级半月板损伤不论病程长短均应尽早进行半月板缝合,Fast-Fix全内缝合法操作简单、疗效可靠,可以广泛运用于半月板损伤治疗过程中。
[Abstract]:Objective: to collect the clinical data of Fast-Fix meniscus suture under arthroscopy and to analyze the correlation between the course of disease and the clinical effect after meniscus suture so as to provide the basis for clinical treatment. Methods: from 2011 to 2013, we selected 76 patients who were hospitalized in orthopedics department of Sichuan traditional Chinese Medicine Hospital and 81 patients with knee joint. The general data of the patients were collected: course of disease, sex, age, injury location, injury form. According to the criteria of Keene duration, the patients were divided into three groups according to the course of the disease: group A: group B: 32 cases in acute stage, group B: group C in subacute stage: group C: 19 cases in chronic stage. The meniscus injury was evaluated by MRI and 10 meniscus suture under arthroscopy. Visual analogue scale (vas), knee function Lysholm and meniscus healing were evaluated by visual analogue score (VAS) before operation and 6 months after operation and 12 months after operation by Barrett standard [2]. According to the results, the correlation between the course of disease and the clinical effect after meniscus suture was analyzed. Results all 76 patients were followed up. The results showed that the difference of VAS score before and after operation was statistically significant (P 0.05). The Lysholm score of knee joint function before and after operation was significantly different (P 0.05). According to the Barrett standard, the clinical healing rate of group A was 96.8888% and that of group B was lower than that of group B. The clinical healing rate of group C was 89.47. The overall clinical healing rate of meniscus injury treated by Fast-Fix total suture under arthroscopy was 93.42.AmeBHN C after operation. There was no significant difference in VAS score of pain in 12 months between the three groups. There was no significant difference in VAS score of knee joint work 3 months after operation between the three groups. There was significant difference in Lysholm score between the three groups (P 0.05), but there was no significant difference in the Lysholm score of knee joint function at 6 and 12 months after operation. There was no significant difference in the clinical healing rate of meniscus in the three groups after operation (P 0.05) and the meniscus healing rate in 12 months (P 0.05). Conclusion: total Fast-Fix suture under arthroscopy is an effective method for meniscus injury. The overall clinical healing rate is 93.42. Early suture was beneficial to the recovery of knee function, but the duration of the disease had no significant effect on the long term clinical effect after meniscus suture. It is suggested that the Fast-Fix total suture of meniscus suture should be carried out as early as possible in grade 鈪，

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