关节镜手术治疗青年前交叉韧带合并半月板损伤的短期预后分析  

Short-term Prognosis of Anterior Cruciate Ligament Combined with Meniscus Injury Treated by Ar-throscopic Surgery

作　　者：曾昭池[1] 陈斌[2] 阳波[1] 朱志勇[1] 汤勇[1] 

机构地区：[1]解放军第一六九医院、湖南师范大学附属湘南医院骨科中心,湖南衡阳421002 [2]解放军第一六九医院、湖南师范大学附属湘南医院院办,湖南衡阳421002

出　　处：《医学临床研究》2017年第4期645-647,650,共4页Journal of Clinical Research

基　　金：湖南省卫生计生委2015年度科研计划课题项目（C2015-29）

摘　　要：【目的】分析关节镜手术对青年前交叉韧带（Anterior cruciate ligament，ACL）合并半月板损伤患者短期预后的影响，探讨其临床应用价值。【方法】选取本院2014年5月至2016年5月收治的129例ACL合并半月板损伤的青年患者，均实施关节镜手术治疗；观察不同Oannr FLF分类患者术前、术后3个月国际膝部文件委员会（IKDC）主观膝部评分及Lysholm膝关节评分变化，并比较不同分类半月板损伤患者临床疗效的差异，总结其短期预后。【结果】129例患者手术均顺利实施，无中转开放手术者，术后恢复良好，切口均Ⅰ期愈合，未见严重并发症发生，均获得有效随访。不同（Yannr FLF分类患者术后3个月IKDC评分、Lysholm评分均较术前升高，差并有统计学意义（P〈0．05）。患者术后3个月膝关节活动均恢复正常范围，未见疼痛、肿胀、交锁症状，O’annrFLF分类为纵裂者，其临床优良率高于其他分类，差异有统计学意义（P〈o．05）。【结论】关节镜手术治疗不N分类ACL合并半月板损伤均可取得较好的短期预后，且不会导致严重并发症发生，具有确切的近期疗效与安全性。[Objective]To analyze short-term prognosis of arthroscopic surgery Ior me treatment oi anterior cruciate ligament （ACL） combined with meniscus injury in youth and to explore its clinical application value. [Methods]A total of 129 cases of youth with ACL and meniscus injury from May 2014 to May 2016 were collected for the study. Patients were classified according to O ＂annr FLF and were all treated by arthroscopic surgery. Sub- jective evaluation of knee scores based on the criteria of international knee document committee council （IKDC） and Lysholm were recorded at preoperation and at 3 months postoperation. Clinical efficacy and short-term progno- sis among patients with different meniscus injuries were compared and statistically analyzed.[Results]Arthroscopy was successfully implemented on all 129 patients （open surgery was not necessary）, and the postoperative recovery was good （phase Ⅰ healing of incision） at the 3-month follow-up. No serious complications occurred. The scores of both IKDC and Lysholm among patients with different O ＂annr FLF classifications were higher at 3-moth postoper- ation than those at preoperation; the differences were statistically significant （ P〈0.05）. The patients＇ knee activi- ties restored to normal within 3 months after surgery without pain, swelling or joint lock symptoms. Patients with longitudinal crack knees according to O ＇annr FLF classification had better results compared to those of other clas- sifications, and the difference was statistically significant （ P〈0.05）. [Conclusion]Arthroscopic surgery on dif- ferent classifications of ACL combined with meniscus injury can achieve very good short-term prognosis without serious complications. It is a safe and effective way to treat ACL with meniscus injury in youth.

关 键 词：关节镜检查 前交叉韧带 半月板 胫骨/损伤 预后 

分 类 号：R684[医药卫生—骨科学]