一期和分期多组韧带重建术治疗外伤性膝关节脱位的临床效果比较

发布时间：2018-11-26 16:43

【摘要】：目的对比分析外伤性膝关节脱位患者经一期和分期多组韧带重建术治疗后的临床效果。方法选择2010年10月~2015年6月安徽医科大学第一附属医院骨科运动创伤与关节镜病区收治的53例外伤性膝关节脱位患者,其中一期手术重建所有韧带者34例(一期组),分期手术重建韧带者19例(分期组)。比较两组的住院费用、康复时间以及手术前后疼痛视觉模拟评分(VAS)、膝关节活动度、Lysholm膝关节评分和IKDC膝关节主观评分,记录并发症发生情况。结果一期组住院费用为58563±7871元,分期组为68620±12055元;两组比较有统计学差异(P0.01)。一期组康复时间为(7.1±1.1)个月,分期组为(10.1±1.0)个月;两组比较有统计学差异(P0.01)。与术前比较,两组术后VAS均降低,膝关节活动度、Lysholm膝关节评分、IKDC膝关节主观评分均升高(P均0.05)。两组术后VAS、膝关节活动度、Lysholm膝关节评分、IKDC膝关节主观评分比较差异无统计学意义(P均0.05)。一期组出现止血带反应3例、切口一期愈合不良1例,并发症发生率为11.8%;分期组出现止血带反应1例,并发症发生率为5.3%;两组并发症发生率比较P0.05。结论一期和分期多组韧带重建术治疗外伤性膝关节脱位均安全、有效,而采用一期韧带重建术治疗的患者花费更少、康复时间更短。
[Abstract]:Objective to compare and analyze the clinical results of traumatic dislocation of knee joint after one-stage and multi-group ligament reconstruction. Methods from October 2010 to June 2015, 53 patients with traumatic dislocation of knee joint were treated in the Department of Orthopedic Trauma and arthroscopy of the first affiliated Hospital of Anhui Medical University. There were 19 cases of ligament reconstruction by stage operation (staging group). (VAS), knee motion, Lysholm knee score and IKDC knee subjective score were compared between the two groups in terms of hospitalization cost, rehabilitation time and pain visual analogue score before and after operation. The incidence of complications was recorded. Results the cost of hospitalization was 58563 卤7871 yuan in the first stage group and 68620 卤12055 yuan in the staging group, there was significant difference between the two groups (P0.01). The recovery time was (7.1 卤1.1) months in the primary group and (10.1 卤1.0) months in the staging group, with statistical difference between the two groups (P0.01). Compared with those before operation, VAS decreased, knee motion, Lysholm knee score and IKDC knee subjective score increased in both groups (P < 0. 05). There was no significant difference in VAS, knee motion, Lysholm knee score and IKDC knee subjective score between the two groups (P 0.05). There were 3 cases of tourniquet reaction and 1 case of poor wound healing in one stage group, the incidence of complications was 11.8%, and that of stage group was 1 case (5.3%). The complication rate of the two groups was higher than that of the control group (P 0.05). Conclusion One-stage and multi-group ligamentous reconstruction is safe and effective in the treatment of traumatic dislocation of knee joint, while the patients treated with one-stage ligamentum reconstruction are less expensive and have shorter rehabilitation time.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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