关节镜手术治疗老年性骨关节炎半月板不同类型损伤患者的临床研究  

Clinical study of arthroscopic surgery for different types of menopausal meniscus injury in elderly patients with osteoarthritis

作　　者：穆胜凯 王景续 宫树一[1] 沈永乐[1] Mu Shengkai;Wang Jingxu;Gong Shuyi(Department of Spine Surgery,Shenyang Orthopedic Hospital,Shenyang 110044,China)

机构地区：[1]沈阳市骨科医院脊柱外科,110044

出　　处：《中华保健医学杂志》2018年第6期506-509,共4页Chinese Journal of Health Care and Medicine

摘　　要：目的探讨关节镜手术治疗对老年性骨关节炎半月板不同类型损伤患者的临床效果,为半月板损伤患者临床治疗方案提供一定的参考依据。方法回顾性选取2016年3月～2017年3月期间沈阳市骨科医院收治的老龄半月板损伤患者220例,依据患者的临床病症选择适宜的手术方式缝合或切除进行关节镜手术,通过对比应用缝合及切除两种不同治疗方法患者术后lysholm评分及炎性因子表达的影响等结果来评价关节镜手术治疗临床效果。此外,通过对患者临床不同关节撕裂类型术后优良率的对比以及术后随访进一步评估影响关节镜手术临床疗效潜在因素。结果采用关节镜手术治疗后,缝合与切除手术方式的术后lysholm评分对比,差异无统计学意义(P> 0.05),术后3个月,两组lysholm评分差异具有统计学意义(P <0.05);术后6、12个月两组lysholm评分差异无统计学意义(P> 0.05)。纵行撕裂术后优良率最佳,达到91.1%,变异型撕裂术后优良率最差,为73.2%,不同撕裂类型的术后优良率对比差异有统计学意义(P <0.05)。手术后两种治疗方式患者的IL-1、IL-2、TNF-α等炎性因子浓度均有所下降,手术前后炎性因子比较差异有统计学意义(P <0.05)。缝合及切除两种治疗方式对内侧半月板损伤患者术后lysholm评分及炎性因子表达组间差异无统计学意义(P> 0.05)。结论关节镜手术治疗下缝合或者切除方式对老年性骨关节炎半月板损伤患者治疗效果大致相同,半月板损伤的术后优良率与损伤类型相关。Objective To explore the clinical effect of arthroscopic surgery on patients with different types of meniscus injury in senile osteoarthritis,and provide a reference for the clinical treatment of meniscus injury patients.Methods A total of 220 patients with aging meniscus injury admitted to our hospital from March 2016 to March 2017 were retrospectively selected for arthroscopic surgery.The patients with different treatments were treated with suture or resection.The scoring situation,as well as the effect of two different treatments,suture or resection,on the lysholm score and the expression of inflammatory factors in patients with medial meniscus injury to evaluate the clinical effect of arthroscopic surgery.In addition,through the different types of joint tears in patients,the comparison of the excellent and good rate and postoperative follow-up further evaluated the potential factors affecting the clinical efficacy of arthroscopic surgery.Results After arthroscopic surgery,there was no statistically significant difference between the average scores after suture or resection.(P>0.05).There was a statistically significant difference in lysholm scores after three months of operation(P<0.05).After six months and twelve months the difference of lysholm score comparison was not statistically significant(P>0.05).Through the analysis of the excellent rate of various types of tears,the results showed that the exllent and good rate after longitudinal tear was achieved.91.1%,the worst rate after modified tear was 73.2%,and there was a statistically significant difference in postoperative and postoperative rate of different tear types(P<0.05);The concentrations of inflammatory factors such as IL-2,TNF-αand so on were decreased,and the difference was statistically significant(P<0.05).There were no significant differences in postoperative lysholm scores and expression of inflammatory factors in the medial meniscus injuries between suture and resection(P>0.05).Conclusion Arthroscopic surgery for suture or resection is simil

关 键 词：关节镜 半月板 老龄患者 撕裂类型 

分 类 号：R684[医药卫生—骨科学]