臀肌挛缩症双侧一期关节镜下松解与开放松解的临床疗效分析  

Comparative analysis of clinical efficacy of one-stage bilateral arthroscopic surgery and open release for gluteal muscle contracture

作　　者：鲁昕[1] 钱军[1] 杨波[1] 林进[1] 翁习生[1] 张嘉[1] 张保中[1] 沈建雄[1] 田野[1] 赵宏[1] 王以朋[1] 范彧[1] 王炜[1] LU Xin;QIAN Jun;YANG Bo;LIN Jin;WENG Xisheng;ZHANG Jia;ZHANG Baozhong;SHEN Jianxiong;TIAN Ye;ZHAO Hong;WANG Yipeng;FAN Yu;WANG Wei(Department of Orthopaedics,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院,北京协和医院骨科,北京100730

出　　处：《中华骨与关节外科杂志》2020年第10期836-839,共4页Chinese Journal of Bone and Joint Surgery

摘　　要：背景:臀肌挛缩症十分常见,常会导致不同程度的髋关节功能受限,目前常用的手术矫正方法有两种:传统开放松解和关节镜下松解。目的:比较关节镜下双侧一期松解与传统开放松解治疗臀肌挛缩的效果。方法:回顾性研究北京协和医院1995年1月至2018年12月收治的双侧臀肌挛缩患者,其中应用传统开放松解治疗的患者19例,关节镜下臀肌挛缩松解的患者21例。收集患者手术时间、切口长度、术中出血量、术后疼痛、并发症发生率、复发率、髋关节内收活动度、Harris髋关节评分(HHS)等治疗指标。结果:术后随访6~24个月,平均14.8个月。与传统开放手术组相比,关节镜治疗组的平均手术时间更长(P<0.05),但手术切口更小、术中出血量更少、术后疼痛明显减轻(P<0.05)。术后并发症发生率、臀肌挛缩复发率及末次随访时的髋关节内收活动度、HHS评分,两组比较无明显统计学差异(P>0.05)。结论:关节镜下臀肌挛缩松解术安全、有效,相对于传统开放松解手术在保证治疗疗效的基础上在许多明显的优势,值得推广。Background:Gluteal muscle contracture(GMC)is very common,and it often leads to varying degrees of hip joint dysfunction.There are two commonly used surgical correction methods:open release surgery and arthroscopic release surgery.Objective:To compare the clinical efficacy of open surgery and one-stage bilateral arthroscopic release for GMC.Methods:Bilateral GMC patients who underwent surgical treatment in our hospital between January 1995 and December 2018 were collected.Of them,19 underwent traditional open release surgery and 21 received arthroscopic release surgery.Operation time,incision length,intraoperative blood loss,postoperative pain,complication rate,recurrence rate,hip adduction,and Harris hip score(HHS)were recorded.Results:All the patients were followed up for 14.8 months on average(range,6-24 months).Compared with traditional open release surgery,arthroscopic release surgery had longer operation time,shorter incision length,less intraoperative bleeding and lower postoperative VAS score(P<0.05).However,there were no statistical difference between two groups in the complication rate,recurrence rate,degree of hip adduction,or HHS at the last follow-up(P>0.05).Conclusions:Arthroscopic release is a safe and effective method for the treatment of GMC.It has many advantages as compared with traditional open release surgery and is worthy of promotion in clinic.

关 键 词：臀肌挛缩症 关节镜松解 微创手术 

分 类 号：R687.4[医药卫生—骨科学]