微创全膝关节置换术的早期疗效观察  

Observation of early efficacy of total knee arthroplasty via minimally invasive surgery

作　　者：李煜明[1] 

机构地区：[1]南京市市级机关医院骨科,江苏省南京市210008

出　　处：《实用老年医学》2012年第6期472-474,共3页Practical Geriatrics

摘　　要：目的探讨微创全膝关节置换术的早期疗效。方法对60例(70膝)入组患者随机分成2组进行前瞻性对照研究。微创组取股内侧肌下切口入路,采用美国捷迈公司特殊的微创器械,利用膝关节屈伸位置的不断变化和"移动窗口"技术行微创全膝关节置换术。对照组采用标准全膝关节置换手术。比较2组病例的膝关节评分(knee society score,KSS)、关节活动度(ROM)增加度数、视觉模拟评分法(VAS)、引流管出血量、切口长度和术后无协助负重行走时间(下地时间)等指标。结果术后1周KSS评分、引流管出血量、切口长度和术后无协助负重行走时间(下地时间)方面,微创组手术效果优于传统对照组,2组差异有统计学意义(P<0.05)。术后12月2组KSS评分、ROM增加度数、VAS比较,差异无统计学意义(P>0.05)。结论微创全膝关节置换术具有手术切口小、出血少、股四头肌功能干扰少等优点,可以减轻术后疼痛,尽早恢复下肢活动,短期随访手术效果优良。Objective To investigate the early efficacy of total knee arthroplasty（TKA） via the minimally invasive surgery（MIS） techniques. Methods Sixty patients（seventy knees） were divided into two groups randomly to finish a prospective controlled study. One group with MIS-techniques began from cutting the vastus medialis muscle, using the change of the knee flexor-extensor position and moving-window technique to finish the TKA with ZIMMER Companys special appliances. The control group used the standard TKA. The KSS score, ROM,VAS,ammout of bleeding from drainage, length of the incision and the weight-bearing walking time were detected and compared between two groups. Results The KSS score, ammout of bleeding from drainage, length of the incision and the weight-bearing walking time in MIS group were better than those in control group（P0.05）. There were no significant difference between two groups in KSS score, the increased degree of ROM and the VAS after 12 months from operation. Conclusions TKA via the MIS-techniques has advantages such as shorter incision, less bleeding and better function of quadriceps, which can relieve the pains of operation and revive the action of legs. The effect of TKA was excellent in short time follow-up.

关 键 词：全膝关节置换术 微创外科 疗效 

分 类 号：R687.4[医药卫生—骨科学]