等离子体低温消融术在膝关节镜手术中应用  

Use of radiofrequency energy in knee during arthroscopic surgery

作　　者：段小军[1] 杨柳[1] 陈光兴[1] 郭林[1] 唐康来[1] 戴刚[1] 代伟[1] 

机构地区：[1]第三军医大学西南医院关节外科中心,重庆400038

出　　处：《重庆医学》2006年第20期1837-1838,1840,共3页Chongqing medicine

摘　　要：目的总结等离子体低温消融术在膝关节镜手术中的应用效果。探讨其使用指针、技巧和并发症的防治。方法2003年8月～2006年2月，在本中心1802例膝关节镜手术中对1868膝进行了等离子体低温消融术、包括有半月板成形、滑膜及皱壁切除、软骨缺损修整、交叉韧带残端及髁间窝清理、包块切除、外侧支持带松解和前交叉韧带紧缩等、术后辅助其他常规处理措施。结果等离子体低温消融术使损伤半月板修整等膝关节内软组织手术更易完成。且组织切除或修整边缘平整．对周围正常组织损伤小。术后住院期间观察显示，1868膝中有7例滑膜广泛切除患者存在浮髌试验阳性，治疗后消失；1例胫骨结节旁皮肤浅Ⅱ^＋烫伤，换药后痊愈；切口均甲级愈合，无肢体感觉障碍和下肢深静脉血栓形成等并发症。保持关节腔内持续的液体灌注、控制消融设备能量强度和刀头与组织间距离可以有效的预防并发症。结论等离子体低温消融术作为一种新的射频气化技术．具有良好的低温切除作用，副损伤小．在膝关节镜手术中具有重要的治疗作用。Objective To analyze the effect of radiofrcquency energy in the knee during arthroscopic surgery. Methods Meniscectomy, synovectomy, resection and debridement of cruciate ligament stump, treatment of articular cartilage lesion and hemostasis with Arthrocare 2000 were performed in 1802 patients, total 1868 location of lesions in arthroscopic surgery of knee joint from August 2003 to February 2006. Results Radiofrequency coblation technology was effective for treatment of menisci injury, chondral lesions, debridement in operation reconstruction of cruciate ligament, tightening of the anterior cruciate ligament, solution of lateral retinaculum and resection of tumor. It had advantages of less injury, quick recovery and no influence on knee function. Seven cases had positive floating patella test after extensive synovectorny, one case had a small area of empyrosis and all cases were healing well soon. No case had severe complication, such as poor wound healing, infection, sensory disability and deep venous thrombosis. Conclusion Radiofrequency energy may become a safe and efficacious treatment option for disease of knee during arthroscopic surgery in the near future.

关 键 词：射频 低温切除 关节镜 膝关节 

分 类 号：R687.3[医药卫生—骨科学]