前交叉韧带重建术后康复期应用透明质酸钠凝胶的疗效分析  

Effective analysis of medical sodium hyaluronate gel on postoperative rehabilitation after anterior cruciate ligament reconstruction

作　　者：杨自权[1] 冯军宇 张晨[1] 赵永亮[1] 姬健钧 谭利[1] 

机构地区：[1]山西医科大学第二医院骨科骨与软组织损伤修复山西省重点实验室,山西太原030001

出　　处：《中国骨伤》2016年第4期311-315,共5页China Journal of Orthopaedics and Traumatology

基　　金：国家自然科学基金资助项目(编号:30973048);国际科技合作项目(编号:2010DFA32450);山西省2014年度留学人员科技活动项目择优资助项目~~

摘　　要：目的 ：分析在关节镜下前交叉韧带重建术术后康复期第2阶段应用透明质酸钠凝胶的疗效。方法：回顾分析2013年1月至2014年1月行关节镜下单侧腘绳肌前交叉韧带重建术治疗前交叉韧带损伤的患者126例,分为两组：医用透明质酸凝胶注射72例：男39例,女33例,年龄18-43岁,平均（28.27±12.30）岁,病程1-40 d,平均25 d,于前交叉韧带重建术后1个月行透明质酸钠凝胶注射的患者,每周注射1次,连续注射3次;透明质酸钠凝胶未注射54例：男21例,女33例,年龄16-45岁,平均（29.14±10.23）岁,病程1-36 d,平均26 d,前交叉韧带重建术1个月后未行透明质酸钠凝胶注射的患者。对两组患者术后6个月之内的临床资料进行比较。采用轴移试验和Lachman试验检查患者的膝关节稳定性,在对术后4、6、8、12、24周时患者在该段康复期的Lysholm评分、关节活动度、股四头肌肌围的关节功能进行比较。结果：重复测量分析结果显示：两组的Lysholm评分、大腿周径在各时间点和组间交互差异无统计学意义（P〉0.001）,两组关节活动度各时间点与组间交互比较差异有统计学意义（F=197.354,P〈0.001）。Lysholm评分及大腿周径在注射后6、8、12、24周注射组均优于未注射组,统计结果有统计学意义（P〈0.001）;在术后6周与8周关节活动度组间比较差异有统计学意义（P〈0.001）,注射组优于未注射组。结论：关节镜下前交叉韧带重建术后康复期第2阶段应用透明质酸钠凝胶可以在术后康复期较好的提高患者的各项膝关节功能,在膝关节活动度的恢复中有确切疗效,远期疗效还需进一步观察研究。Objective：To assess the effect of medical sodium hyaluronate gel injection on the second stage of postoperative rehabilitation of anterior cruciate ligament（ACL） reconstruction.Methods：From January 2013 to January2014,126 patients underwent unilateral ACL reconsruction with hamstring autograft were reviewed.These patients were divided into two groups according to medical sodium hyaluronate gel injection history：in group medical sodium hyaluronate gel injection,54 patients were treaded with medical sodium hyaluronate gel injection on the second stage of postoperative rehabilitation,once a week,three times in a row,including 39 males and 33 females with an average age of（28.27±12.30）years old ranging from 18 to 43 years old,the course of disease was 1 to 40 days（averaged 25 days）.In control group,54 patients who did not treat with medical sodium hyaluronate gel injection including 21 males and 33 females with an average age of（29.14±10.23） years old ranging from 16 to 45 years old,the course of disease was 1 to 36 days（averaged 26 days）.Clinical data during 6,month postoperation were compared between two groups,including Lysholm score,range of motion（ROM） and circumference of thigh at the time point on 4,8,12 and 24 weeks after operation.The stability of the knee was evaluated by the Lachman test and pivot,shift test.Results：Repeated analysis result showed that there was interact at different time point and between groups on the of ROM（F=197.354,P〈0.001）,but there were no statistically significance on the Lysholm score and circumference of thigh（P〈0.001）.Lysholm score and circumference of thigh of medical sodium hyaluronate gel injection group were better than those of control group at all the time point,the difference had statistically significant（P〈0.001）.ROM of medical sodium hyaluronate gel injection group was higher than control group at the time point on 6 and 8weeks after operation,the difference had statistically significant（P〈0.001）.Conclusion：Med

关 键 词：康复 透明质酸钠凝胶 前交叉韧带 修复外科手术 

分 类 号：R686.5[医药卫生—骨科学]