关节镜手术治疗儿童症状性外侧盘状半月板的疗效及影像学评价  

EFFICACY AND IMAGING EVALUATION OF ARTHROSCOPIC SURGERY FOR MATIC LATERAL DISCOID MENISCUS IN CHILDREN

作　　者：刘昊 孙晓新 柴宏伟 梁春雨 文世强 张柳 Liu Hao Sun Xiaoxin Chai Hongwei et al(Department of Arthrosis ,North China University of Science and Technology Affiliated Hospital, Tangshan 063000 ,Chin)

机构地区：[1]华北理工大学附属医院,河北省唐山市063000 [2]哈尔滨医科大学

出　　处：《中国煤炭工业医学杂志》2017年第9期1005-1009,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省科技支撑项目(编号:152777139)

摘　　要：目的研究关节镜手术治疗儿童症状性外侧盘状半月板的疗效及影像学评价。方法选择2008年3月—2016年6月该院骨科收治的85例症状性外侧盘状半月板损伤患儿,所有患儿均于关节镜下行手术治疗,且术后适时进行肌肉力量及关节活动的训练,观察患儿的疗效、预后效果、术后膝关节功能的改善情况及对活动能力的影响。结果患儿合并撕裂者35例,水平层裂20例,行全切除成形术,12例前外侧缘撕裂合并层状裂患儿行次全切除术治疗,其余18例患儿行成形联合缝合术。所有患儿的关节镜手术均成功完成,84例患儿手术切口为Ⅰ期愈合完好,1例患儿关节内出现感染症状,经相应治疗后好转,2例患儿出现关节肿胀症状,将膝关节内积血穿刺抽出后好转。患儿均在术后3周内开始进行下床全负重行走锻炼,5~6周膝关节活动能力基本恢复正常,未出现再次撕裂或损伤复发进行二次手术患者,患者膝关节活动能力均得到一定的恢复,关节疼痛、交锁及弹响等症状改善,关节镜下手术治疗有效率达到100%。患儿术后膝关节功能改善良好,Lysholm膝关节功能评分及IKDC评分较治疗前均显著升高,且差异有统计学意义(均P<0.05),膝关节的伸直和屈曲活动能力明显增强,较治疗前得到明显改善,差异具有统计学意义(P<0.05)。影像学评价显示:相较治疗前91.8%(78/85)的外侧盘状半月板异常形态发生率,治疗后患儿外侧盘状半月板异常形态发生率为0(P<0.05)。治疗前,患儿各项生活质量的评价分数均较高,患儿日常生活能力和社会行动能力均受到限制,抑郁和焦虑状态严重,经关节镜手术治疗后,患儿各项生活质量的评价分数均明显降低,日常生活及社会行动能力得到明显改善,抑郁及焦虑状态基本消失,与治疗前差异具有统计学意义(P<0.05)。结论关节镜手术治疗儿童症状性外侧盘状半月板创伤小,恢复快,可准确修Objective To evaluate the efficacy and radiographic characteristics of arthroscopic surgery for symptomatic discoid lateral meniscus in children.Methods From March 2008 to June 2016,85 children with symptomatic lateral discoid meniscus injury were treated with orthopedic surgery.All the children underwent surgical treatment under arthroscopy,and the muscle strength and joint activities of the training,and then the children＇s efficacy,prognosis,postoperative knee function improvement and the impact of the ability to move were observed.Results There were 35 cases with tear,20 cases of horizontal fissure,12 cases with anterolateral edge tear combined with lamellar fissure,18 cases received plastic surgery.All children with arthroscopic surgery were successfully completed,84 cases of surgical incision for the first phase of healing,1 case of children within the joint infection symptoms,the corresponding treatment improved,2 cases of children with joint swelling symptoms,the knee intra-articular hemorrhage puncture out after improvement.Children were within 3 weeks after the start of bed full weight exercise,5 to 6 weeks of knee activity back to normal,did not appear to tear or injury recurrence of secondary surgery patients,patients with knee activity get a certain recovery,joint pain,interlocking and bombs and other symptoms improved,arthroscopic surgery to achieve 100% efficiency.The knee function scores and IKDC scores of the Lysholm knee were significantly higher than those beforetreatment（P0.05）,and the flexion and flexion activity of the knee joint were significantly increased（P0.05）.Radiographic evaluation revealed an abnormal incidence of lateral discoid meniscus compared to 91.8%（78/85）before treatment,and the abnormal incidence of lateral discoid meniscus in children after treatment was 0%（P0.05）.The width of the body after treatment was significantly higher than that before treatment（P0.05）.Before and after treatment,the evaluation scores of children＇s quality of life were higher,ch

关 键 词：关节镜手术 症状性外侧盘状半月板损伤 预后 评价 

分 类 号：R687.4[医药卫生—骨科学]