关节镜在四肢皮下或肌间血管瘤微创治疗中的应用  

The Application of Arthroscopic Excision on Subcutaneous or Intramuscular Hemangioma

作　　者：李伟[1] 张文涛[1] 江长青[1] 杨恒 肖德明[1] 张新涛[1] 黄伟[1] 石俊俊[1] 雷雪萍[1] 曾少婷[1] 

机构地区：[1]北京大学深圳医院运动医学和康复科,深圳518036 [2]吉林省中研医院外一科,长春132012

出　　处：《中国微创外科杂志》2014年第1期16-18,21,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：广东省自然科学基金项目(8151803601000013)

摘　　要：目的探讨关节镜在四肢皮下或肌间血管瘤切除术中应用的临床价值。方法2011年1月～2013年4月，48例四肢皮下或肌间血管瘤患者，根据术者不同分为2组各24例，关节镜组应用关节镜在皮下层或肌层分离形成腔隙，用刨削刀将血管瘤切除，并用射频刀止血。开放组采用传统开放切开术式。比较2组的手术时间、出血量，术后随访手术瘢痕长度、术区疼痛麻木不适感、外观满意度及复发、感染。结果2组手术时间差异无显著性（P〉0．05）。与开放组比较，关节镜组出血少[（1．0±0．6）ml vs．（12．1±5．9）ml，t=-9．156，P=0．000]，切口瘢痕短[（0．60±0．16）cmVS．（10．20±5．42）cm，t=-8．653，P=0．000]，疼痛麻木不适感轻（1＋1±0．8VS．2．1±1．0，t=-3．934，P=0．000），美观满意度高（8．4±1．3vs．5．3±1．5，t=7．505，P=0．000）。术后随访2—24个月，平均13个月，无复发、感染。结论关节镜在皮下或肌间血管瘤切除中安全可行，手术创面小，美观满意度高，达到了微创治疗与美容的效果。Objective To investigate the clinical value of arthroscopic excision on the subcutaneous or intramuscular hemangioma of limbs. Methods Forty-eight patients with subcutaneous or intramuscular hemangioma were divided into two groups from January 2011 to April 2013. In the aIthroscopic group（n = 24） , guided by arthroscope, cavies were created by separation under the skin or in the muscle, where the hemangioma was resected by the shaver and blood was staunched by radiofrequency coblation. The open incision group （ n = 24） used routine traditional open incision. The operative time, blood loss, postoperative scar length, numbness of the surgical area, patients＇ satisfaction with the appearance, recurrence and infection were compared between the two groups. Results No significant difference was found between the two groups in operative time （ P 〉 0.05）. Compared with the open group, the arthroscopic group had less blood loss [ （ 1.0 ± 0.6） ml vs. （ 12.1 ± 5.9） ml, t = - 9. 156,P = 0. 000 ], shorter scar length [（0.60±0.16） cm vs. （10.20 ±5.42） cm, t= -8.653, P=0.000], less pain and numbness in the surgical area （1.1 ± 0.8 vs. 2.1 ±1.0, t= -3.934, P=0.000）, more satisfaction with the appearance in the arthroscopic group （8.4 ±1.3 vs. 5.3 ± 1.5, t = 7. 505, P = 0. 000）. Both groups were followed up for 2 -24 months, with an average of 13 months. No recurrence or infection was found. Conclusion Arthroscopic excision for subcutaneous or intramuscular hemangioma is feasible and safe, with the advantage of better cosmetic effect and minimal invasion.

关 键 词：血管瘤 治疗 关节镜 切除 

分 类 号：R738[医药卫生—肿瘤]