可吸收医用膜在手肌腱损伤一期修复中的应用  

One-stage repair of hand tendon injuries by DIKFIM:a report of 126 cases

作　　者：程青[1] 刘利波[1] 李军尧[1] 

机构地区：[1]广州军区武汉总医院急诊科,湖北武汉430070

出　　处：《现代医学》2011年第1期62-64,共3页Modern Medical Journal

摘　　要：目的：观察可吸收医用膜在手肌腱损伤一期修复中的疗效。方法：126例（285条）肌腱损伤患者为治疗组,均一期采用改良Kessler法缝接肌腱,并用可吸收医用膜包裹,术后早期循序渐进康复锻炼。对照组120例（282条肌腱损伤）予一期改良Kessler法缝接肌腱,术后早期康复锻炼。结果：随访3~24个月,按TAM法评定疗效：治疗组优59例,良52例,可10例,差5例,优良率为88.10%;对照组优45例,良50例,可12例,差13例,优良率为79.17%;两组比较差异有统计学意义（P〈0.05）。结论：修复肌腱损伤应仔细清创,无创操作、良好肌腱吻合技术加可吸收医用膜的应用及早期功能锻炼是肌腱功能恢复的关键。Objective：To investigate the therapeutic effects of one-stage repair of hand tendon injuries by DIKFIM.Methods： 126 patients with（285 tendons） hand injuries were enrolled,86 male and 40 female,aging from 5 to 60 years,with an average of 31.6 years.Forty-two patients were cut by glasses,44 by knife,28 patients by saw and 12 patients got crushed.The flexor tendon injuries（98 cases 182 tendons） in this study consisted of 11 cases（12 tendons） of Ⅰ zone,37 cases（63 tendons） of Ⅱ zone,26 cases（47 tendons） of Ⅲ zone,10 cases（26 tendons） of Ⅳ zone and 14 cases（34 tendons） of Ⅴ zone.The extensor tendon injuries were 28 cases（103 tendons）.Seventy-two patients complicated with injuries of blood vessel and nerve,and 55 patients also hand fingers fractures.All the patients were treated with modified Kessler method to repair tendon and given DIKFIM at one-stage,and were given early rehabilitation step by step.In the control group of 120 patients with（282 tendons） hand injuries,78 patients were male and 42 patients were female,aging from 8 to 62 years,with an average of 33.2 years.Fifty patients were cut by glasses,38 by knife,22 patients saw,and 10 patients crushed.The flexor tendon injuries（88 cases 180 tendons） consisted of 14 cases（14 tendons） of Ⅰ zone,35 cases（64 tendons） of Ⅱ zone,20 cases（44 tendons） of Ⅲ zone,10 cases（22 tendons） of Ⅳ zone and 9 cases（36 tendons） of Ⅴ zone.The extensor tendon injuries were 32 cases（102 tendons）.Sixty-eight patients complicated with injuries of blood vessel and nerve,and 50 patients also hand fingers fractures.All the patients were treated with modified Kessler method to repair their tendons,and were given early rehabilitation.Results： After the treatment,126 patients were followed up from 3 to 24 months.According to TAM standard,59 patients recovered excellently,52 well,10 moderately fine and 5 failed,curative rate being 88.10%（P0.05,compared with the control group）.In control group,45 patient

关 键 词：手 肌腱损伤 可吸收医用膜 缝合技术 功能锻炼 

分 类 号：R641[医药卫生—外科学]