等离子刀在软骨成形术中的作用研究  

Experimental and Clinical Analysis of Radiofrequency in the Role of Chondroplasty

作　　者：黄河[1] 赵建华[1] 桂鉴超[1] 王辉[2] 王黎明[1] 樊克武[1] 宋华荣[1] 

机构地区：[1]南京医科大学附属南京第一医院,南京市210006 [2]淮安市涟水县唐集中心卫生院

出　　处：《骨与关节损伤杂志》2003年第12期818-820,共3页The Journal of Bone and Joint Injury

摘　　要：目的　研究等离子刀在软骨成形术中的作用。方法　对 2 8例膝关节骨性关节炎的患者进行了等离子刀软骨成形术 ,全部病例获得 6～ 1 8个月 ,平均 1 2 1个月随访。随访结果采用Lysholm膝关节功能评分。对 6个新鲜关节退变软骨标本分别进行机械清理和等离子刀软骨成形术 ,实验前后取标本进行显微镜下观察。结果　所有病例膝关节功能良好 ,治疗前膝关节评分为 5 6 5± 7 3,治疗后膝关节评分为 88 3± 9 2 (t=1 4 33,P <0 0 1 )。机械刨削后 ,软骨表面不够平整 ,处理的深度不一致 ,可见到游离的软骨碎屑。等离子刀处理后 ,软骨表面平整 ,处理的深度一致 ,软骨细胞有活性 ,细胞核、胞浆周围的陷窝结构没有改变。结论　等离子刀技术是软骨成形术的最佳治疗方法之一。Objective Purpose to do experimental and clinical analysis of radiofrequency in the role of chondroplasty.Methods Chondroplasty using radiofrequency in 28 cases of osteoarthritis were performed.All cases were followed for an average of 12 1 months(range,6～18 months) evaluated by Lysholm knee function evaluation score.Six fresh degenerative cartilage specimens were processed alternatively by mechanical debridement and radiofrquency chondroplasty.The cartilage lesions harvested before and after the experiments were studied under microscopy.Results All cases got good knee function with preoperative score 56 5±7 3 and postoperative score 88 3±9 2 (t=14 33,P<0 01).The cartilage surface was rough with inconsistent treatment depth and free cartilage debris after mechanical debridement,while the cartilage surface was smooth with consistent treatment depth limited to the superficial layer,beyond which could saw viable chondrocytes located in normal lacunaes.The treated site formed a new cartilage superficial layer.Conclusion Radiofrequency is the first of choice in chondroplasty.

关 键 词：软骨成形术 等离子刀 膝关节骨性关节炎 软骨退变 射频消融 

分 类 号：R684.3[医药卫生—骨科学]