自体腓骨长肌腱和胭绳肌腱重建前交叉韧带术后疗效及移植物磁共振成像形态学变化研究  

Curative effects and magnetic resonance imaging morphological changes of anterior cruciate ligament reconstructions with autologous peroneus longus tendon and autologous hamstring tendon

作　　者：刘仕杰[1] 史福东[1] 王雪臣[1] 崔泽军[1] 武强[1] 钟洪波[2] 

机构地区：[1]河北省唐山市人民医院骨科,063000 [2]河北省唐山市人民医院核磁共振室,063000

出　　处：《中国医药》2016年第10期1538-1542,共5页China Medicine

基　　金：河北省医学科学研究重点课题计划（20130319）

摘　　要：目的探讨前交叉韧带（ACL）断裂后应用自体腓骨长肌腱和胭绳肌腱重建的术后疗效及移植物磁共振成像（MRI）形态学的变化。方法选取2012年5月至2014年9月河北省唐山市人民医院收治的ACL断裂患者35例为研究对象，其中15例（I组）应用自体腓骨长肌腱作为移植物重建修复ACL，20例（Ⅱ组）应用自体胭绳肌腱重建修复ACL。术前和术后3、6、12个月进行Lachman试验及Lysholm评分，比较2组患者疗效；术后6周和3、6、9、12个月进行MRI检查，动态观察2组移植物MRI信号变化。结果2组患者术前和术后3、6、12个月的Lachman试验评估等级和Lysholm评分差异均无统计学意义（均P〉0．05）；术后3、6、12个月Lachman试验评估等级均明显好于术前，Lysholm评分均明显高于术前[Ⅰ组：（71±6）、（85±4）、（89±6）分比（47±5）分；Ⅱ组：（74±8）、（86±3）、（90±6）分比（48±4）分]，差异有统计学意义（P〈0．05）。2组术后6周和3、6、9、12个月自体移植物在愈合过程中MRI表现基本类似。结论自体腓骨长肌腱和胭绳肌腱重建前交叉韧带术后疗效及移植物韧带化MRI形态学变化无明显差异。Objective To explore curative effect and magnetic resonance imaging （MRI） morphological changes of anterior cruciate ligament（ACL） reconstructions with autologous peroneus longns tendon and hamstring tendon. Methods Totally 35 cases of ACL rupture from May 2012 to September 2014 in Tangshan People＇s Hospital were enrolled; 15 patients（group I ） had ACL reconstructions with autologous peroneus longns tendons; 20 patients （group Ⅱ ） had ACL reconstruction with autologous hamstring tendons. Lachman test and Lysholm score were analyzed before operation and 3, 6, 12 months after operation. MRI examination was performed at postoperative 6 weeks and 3, 6, 9, 12 months. Results Lachman test results and Lysholm scores had no significant differences before operation and 3, 6, 12 months after operation between groups （ P 〉 0. 05 ）. After 3, 6, 12 months, Lachman test results were significantly better than those before operation in beth groups （ P 〈 0. 05 ） ; Lysholm scores were significantly higher than those before operation in both groups[group Ⅰ ： （71 ±6）, （85 ± 4）, （ 89 ±6） scores vs （47 ± 5 ） scores ; group Ⅱ ： （74 ± 8 ）, （ 86 ±3 ）, （90 ± 6） scores vs （48± 4） scores ] （ P 〈 0. 05）. MRI manifestations of autogenous graft healing progress were similar in 2 groups at postoperative 6 weeks and 3, 6, 9, 12 months. Conclusion ACL reconstructions with autologous peroneus longus tendon and autologous hamstring tendon have no significant differences of curative effect and MRI manifestation.

关 键 词：前交叉韧带 移植物 腓骨长肌腱 腘绳肌腱 磁共振成像 

分 类 号：R61[医药卫生—外科学]