小切口手术松解对儿童先天性拇指狭窄性腱鞘炎的治疗体会  

Experience in the Treatment of Congenital Tenosynovitis due to Thumb Stenosis in Children

作　　者：宋得夫[1] 马玉龙[1] 王小玮[1] 杨毅军[1] SONG Defu;MA Yulong;WANG Xiaowei(Xi'an Children's Hospital of Shaanxi Province,Shaanxi Xi'an 710032,China)

机构地区：[1]陕西省西安市儿童医院骨科

出　　处：《河北医学》2020年第1期118-122,共5页Hebei Medicine

基　　金：陕西省社会发展科技攻关项目,(编号:2017SF193)

摘　　要：目的: 探讨小切口手术松解对儿童先天性拇指狭窄性腱鞘炎的治疗效果。 方法: 回顾性分析我院2016年7月至2018年7月收治的78例先天性拇指狭窄性腱鞘炎患儿的临床资料,依据手术治疗方法的不同将其随机分为对照组(n=39)与研究组(n=39),对照组采用传统外科手术方式进行治疗,研究组采用小切口手术松解治疗,比较两组临床疗效、手术操作时间、患指功能恢复正常时间、术后住院时间、术后并发症情况及手术前后视觉模拟量表(VAS)评分和关节活动度。 结果: 研究组总有效率显著高于对照组,差异具有统计学意义(P<0.05);研究组手术操作时间、患指功能恢复正常时间、术后住院时间明显短于对照组,差异具有统计学意义(P<0.05);治疗前,两组VAS评分和关节活动度比较无显著差异(P>0.05);治疗后,两组VAS评分较治疗前显著下降(P<0.05),关节活动度较治疗前显著升高(P<0.05);治疗后,研究组VAS评分较对照组显著下降(P<0.05),关节活动度较对照组显著升高(P<0.05);研究组总并发症显著低于对照组,差异具有统计学意义(P<0.05)。 结论: 小切口手术松解治疗儿童先天性拇指狭窄性腱鞘炎具有操作简便、创口小、恢复快(术中即刻恢复患指伸屈功能)、疗效确切等优点,能有效控制疼痛,改善关节活动度,减少术后并发症,是治疗儿童先天性拇指狭窄性腱鞘炎的安全可靠方法,值得临床推广应用。Objective: To investigate the effect of mini-incision technique for congenital trigger thumb release. Methods: The clinical data of 30 children with congenital trigger thumb treated in our hospital from July 2016 to July 2018 were retrospectively analyzed. Patients were randomly divided into control group (n=39) and study group (n=39) according to different surgical treatment methods. The control group was treated with conventional surgical methods, and the study group received the mini-incision technique. Then the clinical efficacy, operation time, recovery time of affected finger function, hospital stay, complications, visual analogue scale (VAS) score and joint activity were compared between the two groups. Results: The total effective rate of the study group was significantly higher than that of the control group (P<0.05), and the operation time, the recovery time of the affected finger function and the hospitalization time of the study group were significantly shorter than those of the control group (P<0.05). VAS score and joint activity between the two groups showed no difference before treatment (P>0.05). After treatment, the VAS score was decreased, meanwhile the joint activity was increased in both groups after treatment, and the observation group had lower VAS score as well as better joint activity than those of the control group (P<0.05). The incidence rate of the complications in the study group was significantly lower than that in the control group (P<0.05). Conclusion: Mini-incision technique for congenital trigger thumb release has the advantages of simple operation, small wound, quick recovery (immediate intraoperative recovery of the affected finger extension and flexion function), definite efficacy, etc. It is a safe and reliable method for the treatment of children with congenital trigger thumb, which is worthy of clinical promotion and application.

关 键 词：小切口手术松解 先天性拇指狭窄性腱鞘炎 临床疗效 

分 类 号：R726.8[医药卫生—儿科]