肥胖对青壮年半月板桶柄状撕裂预后的影响  

EFFECT OF OBESITY ON CLINICAL EFFICACY OF ARTHROSCOPIC SUTURE FOR BUCKET-HANDLE MENISCAL TEARS IN YOUNG ADULTS

作　　者：刘晓光[1] 张益民[2] 王军[2] LIU Xiaoguang;ZHANG Yimin;WANG Jun(Department of Surgery,Weifang Medical University,Weifang 261053,China)

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053 [2]潍坊市人民医院关节外科

出　　处：《青岛大学学报（医学版）》2018年第4期410-414,共5页Journal of Qingdao University(Medical Sciences)

摘　　要：目的研究肥胖因素对青壮年病人半月板桶柄状撕裂预后的影响。方法行半月板桶柄状撕裂修复缝合术病人83例,其中肥胖(体质量指数≥28kg/m2)者35例,非肥胖者48例。共行半月板缝合术88处,其中5例病人同时行内外侧半月板缝合术,随访时间平均22个月。术后应用BARRETT等制定的半月板修复术后临床愈合标准及MRI对病人半月板愈合率进行评估,应用视觉模拟评分法(VAS)进行膝关节疼痛自我感觉评定,应用国际膝关节文献委员会膝关节评分(IKDC评分)、膝关节Lyshlom评分、膝关节Tegner活动评分对手术前后膝关节功能及康复效果进行评定。结果肥胖组和非肥胖组病人比较,术前及术后VAS、IKDC、Lysholm、Tegner评分差异无统计学意义(P>0.05);两组组内术前及术后VAS、IKDC、Lysholm、Tegner评分比较差异有统计学意义(t=5.71~35.77,P<0.05);两组病人术中半月板损伤情况及软骨损伤程度比较差异无统计学意义(P>0.05);肥胖组和非肥胖组半月板缝合完全愈合率分别为83.8%(31/37)和86.3%(44/51),两组比较差异无统计学意义(P>0.05)。结论肥胖因素对青壮年病人半月板桶柄状撕裂预后无明显影响。Objective To investigate the effect of obesity on the clinical efficacy of arthroscopic suture for bucket-handle meniscal tears in young adults. Methods According to the body mass index（BMI）,83 patients with bucket-handle meniscal tears who underwent arthroscopic suture were divided into obesity group（n=35,BMI≥28 kg/m2）and non-obesity group（n=48）.Of the 83 patients,5 had both medial and lateral meniscal injuries,resulting in a total of 88 meniscal injuries.The mean follow-up was 22 months.After surgery,the meniscal healing was evaluated using Barrett criterion and postoperative magnetic resonance imaging findings.The knee pain was evaluated using Visual Analogue Scale（VAS）score.The International Knee Documentation Committee（IKDC）score,Lysholm score,and Tegner score were used to evaluate the knee function before and after surgery and rehabilitation outcome of all the patients. Results There were no significant differences in VAS score,IKDC score,Lysholm score,and Tegner score between the two groups before or after surgery（P〉0.05）.Both groups had significant improvements in VAS score,IKDC score,Lysholm score,and Tegner score after surgery（t=5.71-35.77,P〈0.05）.There were no significant differences in the degrees of meniscal injury and cartilage injury during the surgery between the two groups（P〉0.05）.There was no significant difference in the complete healing rate of meniscal injury between the obesity group and the non-obesity group（83.8%（31/37）vs 86.3%（44/51）,P〉0.05）. Conclusion Obesity has no significant effect on the clinical efficacy of arthroscopic suture for bucket-handle meniscal tears in young adults.

关 键 词：半月板 胫骨 治疗 肥胖 青壮年 

分 类 号：R681.7[医药卫生—骨科学]