玻璃酸钠预防肌腱缝合术后粘连作用分析  

Analysis of effects of Sodium Hyaluronate on preventing adhesion after tendon suture

作　　者：陈明金[1] 

机构地区：[1]福建省石狮市医院急诊科,福建石狮362700

出　　处：《中国当代医药》2017年第16期79-82,共4页China Modern Medicine

基　　金：福建省石狮市科技计划项目(2015SK09)

摘　　要：目的探讨玻璃酸钠对肌腱缝合术后粘连的预防作用及对术后手部功能的影响。方法选取2014年3月~2016年12月我院收治的74例手外伤伴至少有1条手指伸肌腱或屈肌腱断裂患者作为研究对象,按随机对照、自愿原则分为对照组(伸肌腱27例,屈肌腱10例)和治疗组(伸肌腱27例,屈肌腱10例),各37例。对照组采用改良Kessler缝合法,局部不使用玻璃酸钠;治疗组采用改良Kessler缝合法,加用玻璃酸钠外涂肌腱缝合接头,或修补腱鞘后用注射器将玻璃酸钠直接注入。观察并记录两组治疗1、2、3个月后的手指总主动活动度(TAM)状况,比较治疗3个月伸、屈肌腱断裂临床治疗效果,同时记录患者是否发生肌腱粘连并发症。结果两组治疗1、2、3个月后的手指总主动活动度高于治疗前,差异有统计学意义(P<0.05)。治疗组治疗1、2、3个月后的手指总主动活动度高于对照组,差异有统计学意义(P<0.05)。治疗组治疗3个月后的伸肌腱、屈肌腱优良率高于对照组,差异有统计学意义(P<0.05)。治疗组的肌腱粘连率为5.40%,低于对照组的27.02%,差异有统计学意义(P<0.05)。结论玻璃酸钠能有效缓解肌腱缝合术后粘连,促进术后手部功能恢复,改善患者生活质量,且无明显不良反应,值得临床推广应用。Objective To investigate the preventive effect of Sodium Hyaluronate on adhesion after tendon suture and the influence of hand function.Methods 74 patients with hand injuries accompanied by rupture at least 1 extensor ten- dons or flexor tendons from March. 2014 to December 2016 in our hospital were selected as the subjects,all patients were divided into the control group （27 cases of extensor tendon,10 cases of flexor tendon） and the treatment group （27 cases of extensor tendon,10 eases of flexor tendon） according to random control and voluntary principle,37 cases in each group.The control group was treated with modified Kessler suture,and no Sodium Hyaluronate.The treatment group was treated with modified Kessler suture,and sodium hyaluronate was used to suture the tendon suture,or Sodium Hyaluronate was injected into the tendon sheath,all patients were observed and recorded in 1,2,3 months after the fin- ger total activity （TAM）,and clinical effect of the treatment of flexor tendon rupture were recorded at the same time,the complications of tendon adhesion were compared after 3 months.Results The TAM of the fingers in the two groups after 1,2 and 3 months was higher than that before the treatment,with significant difference （P〈0.05）.The TAM of the fingers in the treatment group after 1,2 and 3 months was higher than that of the control group,with significant difference （P〈 0.05）.The excellent and good rate of extensor tendon and flexor tendon in the treatment group after 3 months was higher than that in the control group,with significant difference （P〈0.05）.The adhesion rate of the treatment group was 5.40%, which was lower than 27.02% of the control group,with significant difference （P〈0.05）.Conclusion Sodium Hyaluronate can effectively relieve tendon adhesion,promote postoperative recovery,improve the quality of life of patients,and no obvious adverse reaction,it is worthy of clinical promotion and application.

关 键 词：玻璃酸钠 肌腱缝合术 肌腱粘连 手指总主动活动度 

分 类 号：R622.9[医药卫生—整形外科]