非关节镜下等离子刀微创治疗儿童注射性臀肌挛缩症  

Non-arthroscopy minimal invasion plasma cutter in the treatment of injection gluteal muscle contracture in children

作　　者：蔡刚[1] 马承宣[1] 李浩宇[1] 于向华[1] 丑小冰[1] 

机构地区：[1]解放军总医院小儿外科,北京100853

出　　处：《军医进修学院学报》2012年第10期1008-1010,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的探讨非关节镜下等离子刀微创治疗儿童注射性臀肌挛缩症的初步疗效。方法自2006年7月-2012年1月我科采用非关节镜监视下等离子刀微创治疗双侧注射性臀大肌挛缩症患儿48例,男性19例,女性29例,年龄4-16岁,平均9.2岁。均行大粗隆下微小切口,骨膜剥离器钝性分离皮下组织与臀肌挛缩带间粘连,形成腔隙,0.9%氯化钠注射液充盈后,插入等离子刀头对臀肌挛缩带行"Z"形切断并松解延长。结果 26例患儿获得随访,随访时间为3月-8年,平均62.4个月。根据步态、并膝下蹲、交腿试验、心理状态和对运动影响进行综合评价,以髋关节恢复活动范围为标准进行疗效评价。优25例,良1例,1例血肿形成,无神经血管损伤。结论粗隆下微小切口,采用离子刀头行臀肌挛缩带"Z"形切断延长术,操作安全,疗效可靠,不需关节镜设备,便于基层推广使用。Objective To study the clinical outcomes of injection gluteal muscle contracture in children after treatment with nonarthroscopy minimal invasion plasma cutter.Methods Forty-eight children（19 males and 29 females） aged 4-16 years（mean 9.2 years） with bilateral injection gluteal muscle contracture were treated with non-arthroscopy minimal invasion plasma cutter.Micro-incision was made below the great trochanter.A space was made by isolating the adhesion between the contracture and the overlying subcutaneous tissue with an elevator and filled with saline.Gluteal muscle contracture was cut in a ＂Z＂ shape and released with the inserted plasma cutter head.The patients consisted of 19 males and 29 females aging from 4-16 years（mean 9.2 years）.Small incisions below the great trochanter were made.A space was made by separating the adhesion between the contracture band and overlying subcutaneous tissue with an elevator,where saline was filled.Contracture band was released by radio frequency vaporization.Results 26 cases were followed up for 3-96 months with an average of 62.4 months.The standard observations were made according to gait,squatting,snapping,crossing legs functions,and movement.Excellent results were achieved in 25 cases,and good in one case.Hematoma happened in one case.No injury to nerve and blood vessels occurred.Conclusion Non-arthroscopy micro-incision below the great trochanter with gluteal muscle contracture cut in a ＂Z＂ shape with the plasma cutter head is a safe,reliable,effective procedure for injection gluteal muscle contracture in children without arthroscopy,and is thus worthy of wide application.It can be used in remote hospitals without the use of arthroscopy.

关 键 词：臀大肌 挛缩 等离子刀 微创 治疗 

分 类 号：R726.86[医药卫生—儿科]