非牵引漂浮体位在前后踝撞击症关节镜手术中的应用  

Surgical method and clinical effect of non-traction floating position in treating ankle impingement

作　　者：张頔[1] 肖蕊[1] 丁琪[2] ZHANG Di;XIAO Rui;and DING Qi(Department of Operating Theater,Beijing Ji Shuitan hospital,Beijing 100035,China;Department of Clinical Laboratory,General Hospital of Chinese People＇s Armed Police Force,Beijing 100039,China)

机构地区：[1]北京积水潭医院手术室,100035 [2]武警总医院检验科,北京100039

出　　处：《武警医学》2018年第7期698-701,共4页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨非牵引漂浮体位在前后踝撞击症关节镜手术中的方法和临床疗效。方法选择2010-01至2015-12医院收治的前后踝撞击症患者32例,随机分为对照组和观察组,每组16例,对照组采用普通仰卧位,观察组采用非牵引漂浮体位关节镜手术,观察两组患者手术时间、手术出血量及手术效果,并对患者进行至少1年临床随访,包括关节活动角度、AOFAS主观功能评分、VAS评分及相关并发症评估。结果观察组手术时间(1.5±0.3)h明显低于对照组手术时间为(2.0±0.4)h(P<0.01);两组出血量均为5~10 ml,无明显差异。对照组患者术后关节背伸角度和跖屈角度均高于术前(P<0.05),观察组患者术后关节背伸角度和跖屈角度均高于术前(P<0.05),两组之间无统计学差异。两组患者术前和术后1个月AOFAS评分及VAS评分均具有明显差异(P<0.05),术后1个月和3个月AOFAS评分及VAS评分均具有统计学差异(P<0.05),但对照组与观察组之间患者评分差异无统计学意义。所有患者手术效果良好,无明显术后并发症。结论前后踝撞击症术中应用非牵引漂浮体位,可一次性处理前后踝骨赘,缩短手术时间,避免术中二次消毒。Objective To explore the method and clinical effect of non-traction floating body position in arthroscopic surgery.Methods Thirty-three patients with anterior and posterior ankle impingement were randomly divided into the control group and observation group. The normal supine position was adopted in the control group,while non-traction floating body arthroscopic surgery was used in the observation group. The duration of surgery,blood loss and surgical effect were observed in the two groups of patients,and follow-up of at least one year involved the angle of the joints,AOFAS subjective function score,VAS score and related complications.Results The duration of surgery was（ 1. 5 ± 0. 30） h in the observation group,and（ 2. 0 ± 0. 4） h in the control group（ P〈0. 01）.The blood loss volume was 5-10 ml in both groups,so there was no significant difference. The stretching back angle and plantar flexion angle of patients in the two groups became larger after treatment（ P〈0. 05）,but there was no statistically significant difference between the two groups. There was significant difference between the two groups of patients before treatment and one month postoperatively in the AOFAS score or VAS score（ P〈0. 05）,there was statistically significant difference one month and three months after operation（ P〈0. 05）,but the scores of the control group and observation group patients were not significantly different. The surgical effect was good in all the patients,with no obvious postoperative complications. Conclusions Ankle impingement treated by non-traction floating position can remove the osteophyte of ankles,simplify surgical procedures,prevent secondary disinfection during surgery and achieve satisfactory clinical efficacy.

关 键 词：漂浮体位 踝关节 撞击伤 

分 类 号：R687.4[医药卫生—骨科学]