肌腱骨吻合装置修复肌腱末端损伤的临床研究

发布时间：2018-06-16 14:09

本文选题：肌腱骨吻合装置 + 肌腱韧带　；参考：《南华大学》2015年硕士论文

【摘要】：目的探讨肌腱骨吻合装置修复肌腱末端损伤的临床疗效。方法2013年1月至2014年10月我科收治肌腱、韧带末端损伤患者40例,男27例、女13例,年龄17-69岁,平均38.30±5.62岁。按修复方法将患者分为三组:实验组(A组,15例):将损伤的肌腱、韧带末端缝合于肌腱吻合部位,再将肌腱骨吻合装置固定在肌腱的骨附着部;钢丝组(B组,15例):将钢丝穿过肌腱、韧带末端编织,在肌腱骨附着部位钻孔,钢丝穿过骨孔,扭紧钢丝,将肌腱固定在骨附着点上;骨锚组(C组,10例):在肌腱附着点骨质钻孔拧入锚钉,用锚钉尾缝合线缝合肌腱、韧带末端,交叉韧带骨锚修复在关节镜下完成。术后石膏固定4周,随访3-20月,平均9.32±1.24月。比较三组患者手术时间、住院时间,术后并发症和功能评价。采用SPSS18.0统计软件处理数据,三组间一般情况比较采用χ2检验,治疗情况比较采用t检验,疗效比较采用秩和检验;检验水准α=0.05。以P0.05表示为有统计学意义。结果手术时间(分钟):A组32.87±4.31、B组41.52±6.22、C组30.50±4.91,B组明显长于A组和C组(P0.05),A组和C组无明显差异(P0.05)。住院时间(天):A组9.64±1.11、B组14.22±1.02、C组8.21±1.35,B组明显长于A组和C组(P0.05),A组和C组无明显差异(P0.05)。术后并发症发生率:A组6.67%、B组33.33%、C组10.00%,A组和C组明显低于B组(P0.05),A组和C组无明显差异(P0.05)。术后功能优良率:A组86.67%、B组66.67%、C组80.00%,A组和C组明显高于B组(P0.05),A组和C组无明显差异(P0.05)。结论①肌腱骨吻合装置修复肌腱末端损伤,具有操作简便、并发症少、临床疗效好等优点,尤其适合于修复大的肌腱韧带末端损伤。②采用可吸收材料制作肌腱骨吻合装置修复肌腱末端损伤,不需二次手术,患者无金属异物存留体内和骨锚移位之忧。
[Abstract]:Objective to investigate the clinical effect of tendon bone anastomosis device in repairing tendon end injury. Methods from January 2013 to October 2014, 40 cases (27 males and 13 females) with tendon injury at the end of ligaments were treated in our department, aged 17-69 years (mean 38.30 卤5.62 years). According to the repair method, the patients were divided into three groups: the experimental group (group A, n = 15): suture the injured tendon and the end of ligament to the tendon anastomosis site, and then fix the tendon bone anastomosis device to the bone attachment of the tendon; 15 cases in group B: the steel wire was woven through the tendon, the end of the ligament was woven, the tendon bone was drilled, the steel wire passed through the bone hole, the steel wire was twisted, and the tendon was fixed on the bone attachment point. In group C, 10 cases were treated with bone anchor. The anchors were drilled into the bone of tendon attachment point, and the tendon was sutured with anchor tail suture line. The end of ligaments and cruciate ligament bone anchors were repaired under arthroscopy. The patients were fixed with gypsum for 4 weeks and followed up for 3 to 20 months (mean 9.32 卤1.24 months). The operative time, hospital stay, postoperative complications and functional evaluation were compared among the three groups. The statistical software SPSS 18.0 was used to process the data, 蠂 2 test was used to compare the general situation among the three groups, t test was used to compare the treatment condition, and the rank sum test was used to compare the curative effect. With P0.05 expressed as statistical significance. Results the operative time in group A (32.87 卤4.31) in minutes (41.52 卤6.22) in group C was significantly longer than that in group A and group C (30.50 卤4.91). There was no significant difference between group A and group C (P 0.05). The length of hospitalization in group A (9.64 卤1.11) and group B (14.22 卤1.02) was significantly longer than that in group A and group C (8.21 卤1.35) and there was no significant difference between group A and group C (P 0.05). The incidence of postoperative complications in group A (6.67) and group C (33.33) were significantly lower than those in group B (P 0.05) and group A (10.00). There was no significant difference between group A and group C (P 0.05). The excellent and good rate of postoperative function in group A was 86.67 and that in group C was higher than that in group A and C. There was no significant difference between group A and group C. there was no significant difference between group A and group C. Conclusion (1) the tendon and bone anastomosis device has the advantages of simple operation, less complications and good clinical effect in repairing tendon end injury. It is especially suitable for repairing the large tendon ligament end injury .2 using absorbable material to make tendon bone anastomosis device to repair tendon end injury without the need of secondary operation.
【学位授予单位】：南华大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.2

【相似文献】