不同手术方式对跟腱中段腱病的疗效  

Effects of different surgical methods on midportion achilles tendinopathy

作　　者：穆峰 张延明[2] 张喜善[2] 丁超 孙莉华 

机构地区：[1]山东省肥城矿业中心医院骨一科,271000 [2]泰山医学院附属医院运动医学科,山东泰安271000

出　　处：《中国矫形外科杂志》2015年第9期769-772,共4页Orthopedic Journal of China

摘　　要：[目的]评估不同手术方式对跟腱中段腱病的疗效。[方法]66例跟腱中段腱病患者采用手术治疗,根据手术方式不同将患者分成A组微创手术治疗组、B组传统开放手术治疗组,对比两组手术的疗效、手术时间、术中出血量、术后并发症、住院天数。分别在治疗前、治疗后即刻、治疗后4、12个月时用VISA-A跟腱腱病评分表进行评分,并在治疗后12个月时采用Likert评分进行患者主观满意度评价。[结果](1)微创手术治疗组在手术时间、术中出血量、住院天数等方面具有明显优势;(2)VISA-A评分:两组患者在治疗前评分无差异,(P>0.05)。A组治疗后即刻、治疗后4个月及治疗后12个月分别为(85.55±12.11)、(94.58±13.11)、(96.55±10.11),B组则分别为(68.63±7.40)、(78.63±6.58)、(82.38±6.65)。A组治疗后各时间点与治疗前的VISA-A评分差值与B组相比,差异有统计学意义(P<0.05);(3)Likert评分:A组中4例非常满意,25例满意,2例不满意,满意率达到93.8%。B组中没有非常满意者,28例满意,6例不满意,满意率为82.4%。微创手术组满意度明显高于传统开放手术组。[结论]微创手术较传统开放手术在治疗跟腱中段腱病上,围手术期有显著优势,具有更良好的长期临床结果,能够更好地提高病人整体的满意度。[Objective] To evaluate the efficacy of different surgical methods on midportion achilles tendinopathy. [Methods] Sixty- six patients with midportion achilles tendinopathy were treated by different surgical methods. The patients were divided into two groups,group A was treated by minimally invasive,and group B treated by open operation. The curative effect of two groups of operation were compared on blood loss,postoperative complications,hospital stay. VISA- A score system was used for assessment before surgery,immediately,4 months and 12 months after surgery,respectively. Likert score system was used for subjective satisfaction assessment in the 12 months. [Results]（ 1） Group A had great advantages in shorter operative time,lesser bleeding and in- hospital times.（ 2） VISA- A score showed no difference in two groups before operation（ P〈0. 05）,and were（ 85. 55 ＋ 12. 11） and（ 94. 58 ＋ 13. 11）,（ 96. 55 ＋ 10. 11） at immediately,4 months and 12 months after treatment in group A,respectively,and were（ 68. 63 ＋ 7. 40） and（ 78. 63 ＋ 6. 58）,（ 82. 38 ＋ 6. 65） at immediately,4months and 12 months after treatment in group B,respectively. The difference was statistically significant（ P〈0. 05） after surgery in two groups.（ 3） Likert score： in group A,4 patients were very satisfied,25 patients were satisfied,2 patients were not satisfied,satisfaction rate was 93. 8%. In group B,no patient was very satisfied,28 patients were satisfied,6 patients were not satisfied,satisfaction rate was 82. 4%. Satisfaction rate in minimally invasive surgery group was significantly higher than that in open surgery group. [Conclusion] Minimally invasive surgery for treatment of midportion achilles tendinopathy has more advantages in perioperative period,with better long- term clinical results compared with open surgery group,and has higher satisfaction rate.

关 键 词：微创治疗 开放手术 跟腱中段腱病 

分 类 号：R687.2[医药卫生—骨科学]