合并前交叉韧带损伤的复合伤一期手术与延迟手术的疗效比较  

Comparison of Therapeutic Effects Between Early and Delayed Surgery in Combined Injury with Anterior Cruciate Ligament Injury

作　　者：易晨阳 黄伟[1] 冯飞[1] 

机构地区：[1]湖北省黄冈市中心医院骨科,湖北黄冈438000

出　　处：《武汉大学学报（医学版）》2013年第6期933-934,964,共3页Medical Journal of Wuhan University

摘　　要：目的:通过对比研究合并前交叉韧带损伤的复合伤一期手术与延迟手术的疗效差异,探讨其最佳治疗时机。方法:以2008年7月至2013年4月期间收治的52例合并前交叉韧带损伤的复合伤患者为研究对象,随机分为一期手术组(29例,55.76%)和保守治疗3个月后延迟手术组(23例,44.24%),通过术后采用Lysholm膝关节评分标准、关节纤维粘连、关节活动度及大腿周径的测量,综合评价两组手术治疗的疗效差异。结果:一期手术组与延迟手术组Lysholm膝关节评分、关节纤维粘连和关节活动度的差异无统计学意义(P>0.05),大腿周径萎缩指数差异有统计学意义(P<0.05),一期手术组大腿周径萎缩指数有显著改善。结论:对于合并前交叉韧带损伤的膝关节复合伤患者,一期手术治疗与延期手术治疗疗效相当,但一期手术术后患者大腿周径萎缩程度有明显改善,且患者可于术后较早进行康复训练,故一期手术是较好的选择。Objective. To compare the therapeutic effects between the early and delayed surgery for com- bined injury with anterior cruciate ligament （ACL） injury. Methods： Fifty-two cases treated with arthroscopic reconstruction of combined injury with ACL injury were selected from July 2008 to April 2013. Among the 52 cases, 29 cases （55.76%） were treated with early surgery and 23 cases （44.24%） were treated with delayed surgery. The therapeutic effects were evaluated according to the Lysholm knee score, arthrofibrosis, stiffness, range of motion, and measurements of thigh circumferences a range of motion fter had surgery. Results： The Lysholm knee score, arthrofibrosis, stiffness, and no obvious differences （P〉0.05） between the two groups, while the differ- ence of thigh circumferences was statistically significant （P〈0.05）. The atrophy index of thigh circumferences had improved obviously for the cases treated with early surgery. Conclusion： The early or delayed surgery has almost the equivalent therapeutic effects for combined injury with ACL injury. However, the early surgery, which can achieve the better atrophy index of thigh circumferences and the earlier rehabilitation training, should be the better choice for combined in- jury with ACL injury.

关 键 词：前交叉韧带 复合伤 一期手术 延迟手术 肌肉萎缩 

分 类 号：R686.5[医药卫生—骨科学]