半月板成形术治疗盘状半月板损伤的预后影响因素研究  

作　　者：刘书华[1] 徐浩[1] 赵嘉懿[1] 

机构地区：[1]浙江省舟山医院,316000

出　　处：《浙江临床医学》2017年第9期1629-1631,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨关节镜下行半月板成形术治疗盘状半月板损伤患者术后功能恢复的影响因素。方法回顾性分析2013年1月至2015年9月73例盘状半月板损伤行膝关节镜下半月板成形术患者的临床资料。其中男44例，女29例。术前记录患者性别、年龄、BMI指数、术前病程等资料，术前及术后功能评价指标包括患侧膝关节VAS疼痛评分，Tegner及Lyrsholm膝关节功能评分，术后评价均在术后12个月进行。根据Lyscholm膝关节评分，将患者分为功能优良组和功能欠佳组。通过两组间比较，筛选出可能的预后影响因素进行Logistic回归分析。结果术后1年，共61例患者疗效优良（优良率83．6％），12例患者疗效欠佳。两组患者的BMI指数，术前病程及年龄、术前Tegner评分差异有统计学意义（P〈0．05）。根据以上结果，选择BMI指数，术前病程及年龄、术前Tegner评分进行多因素Logistic回归分析，回归结果提示年龄[P=0．038；OR 1．092（1．005-1．188）]、BMI指数[P=0．022；OR 1．709（1．079-2．707）]及术前病程[P=0．039；OR1．046（1．002-1．092）]均是预后欠佳的风险因素。结论在行膝关节镜下半月板成形术治疗盘状半月板损伤的患者中，年龄、BMI及术前病程均为影响术后功能恢复的独立危险因素，年龄大、术前病程长，BMI值高的患者术后膝关节功能恢复欠佳的风险较大。Objective To explore and analyze and the factors affecting postoperative function in the patients who have knee discoid meniscus injury treated with arthroscopic meniscus plasty. Methods A retrospective analysis of patients with discoid meniscus injury in our hospital from January 2012 to September 2015. According to the inclusion and exclusion criteria, 73 cases who accepted knee arthroscopic meniscus plasty were enrolled into this study. There were 44 males and 29 females.Preoperative gender, age, BMI, preoperative course of disease were recorded. Preoperative and postoperative functional evaluation indexes including VAS score of knee joint pain, the Tegner knee scale and the Lysholm knee scale. The postoperative evaluation was performed at 12 months after operation. According to The Lysholm knee scale, patients were divided into excellent functional group and dysfunctional group.The comparison between the two groups, Logistic regression analysis was performed to screen the possible prognostic factors. Results 1 year after the operations, the curative effect in 61 patients was excellent （excellent rate 83.6% ） , in 12 patients was unsatisfactory.The difference of BMI, preoperative course, age and the Tegner knee scale of preoperation, was statistically significant （ P〈0.05 ） . Based on the above results, multivariate logstic regression analysis was performed with BMI, preoperative course, age and the Tegner knee scale of preoperation. The results indicated that age [ P=0.038; OR 1.092 （ 1.005- 1.188 ） ] , BMI index [ P=0.022; OR 1.709 （ 1.079-2.707 ） ] and preoperative course [ P=0.039; OR 1.046 （ 1.002-1.092 ） ] were risk factors of poor prognosis. Conclusion In the patients who have knee discoid meniscus injury treated with arthroscopic meniscus plasty, the age, BMI and preoperative course were independent risk factors for postoperative functional/recovery.The patients with large age, long course of disease and high BMI value have a higher risk of postoperative recovery of knee function.

关 键 词：盘状半月板损伤 膝关节镜 半月板成形术 危险因素 功能 

分 类 号：R684.7[医药卫生—骨科学]