肘关节粘连松解术中减少射频消融的使用对术后疗效的影响  

The effect of reduced radiofrequency ablation on postoperative drainage of elbow joint arthrolysis

作　　者：杨春喜 杜琳 刘晓琳[1] 张炜[1] 赵耀超 王友[1] Yang Chunxi;Du Lin;Liu Xiaolin;Zhang Wei;Zhao Yaochao;Wang You(Department of Bone and Joint Surgery,Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200001,China)

机构地区：[1]上海交通大学医学院附属仁济医院骨关节外科,200001

出　　处：《中华肩肘外科电子杂志》2020年第3期232-236,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：上海市科委引导类课题面上项目(16411971700)。

摘　　要：目的对比在肘关节镜下粘连松解术使用射频消融或刨刀进行关节囊松解、炎性滑膜切除对术后关节引流量的影响。方法将上海交通大学医学院附属仁济医院收治的骨关节炎性肘关节粘连患者24例随机分为2组,每组12例。射频消融组:使用射频消融进行滑膜切除和关节松解;刨刀组:使用刨刀进行滑膜切除和关节松解。对比术后关节引流量、关节屈伸活动度、关节功能评分等。结果刨刀组术后引流量为(32.9±12.3)ml显著少于射频消融组(110.0±31.4)ml(P=0.00)。术后引流管留置时间射频消融组为(3.1±1.3)d,显著多于刨刀组的(1.3±0.5)d(P=0.00),但两组间关节活动度、功能评分恢复情况差异无统计学意义。结论进行肘关节镜下粘连松解术时,射频消融的过多使用会增加术后引流量,使用刨刀进行滑膜切除和松解优于射频消融。Background The incidence of elbow osteoarthritis in the adult is nearly 2%,and it can cause elbow joint adhesion,which is manifested by pain in elbow joints,accompanied by various degrees of flexion,extension,and rotation disorders.Elbow joint arthrolysis has attracted much attention in recent years,and the effect of the operation is affirmative.Due to the narrow joint cavity of the elbow joint,extensive joint capsule release and synovial clearance are needed in this operation.There is often more joint exudation after operation,even the incision is delayed to heal.Radiofrequency ablation has been widely used in arthroscopic surgery for joint capsule release,synovial cleaning,hemostasis,etc.However,radiofrequency ablation can cut through the local instantaneous high temperature of the knife head,which will increase the temperature of surrounding tissues and liquid,and even cause extensive thermal damage.Elbow joint space is narrow,which may lead to thermal injury more easily.In addition,radiofrequency ablation or planer knife is needed for extensive synovial clearance,joint capsule release and resection,and ligament insertion release.Therefore,the influence of radiofrequency ablation and planer on the amount of joint exudation after arthrolysis of elbow joint needs to be confirmed.Objective To compare the effect of radiofrequency ablation or planer blade on the postoperative joint drainage in arthroscopic elbow arthrolysis.Methods A total of 24 patients with osteoarthritic elbow adhesions were randomly divided into 2 groups with 12 patients in each group.In the experimental group,radiofrequency ablation was used for synovial resection and joint release.In the control group,synovial resection and joint release were performed with a plane knife.The postoperative joint drainage,joint flexion and extension range and joint func tion score were compared.Results The postoperative drainage volume was(32.9±12.3)ml in the control group,which was significantly lower than that in the experimental group,which was(110.0±31.4)

关 键 词：肘关节 关节镜 关节松解 骨关节炎 引流 

分 类 号：R687.4[医药卫生—骨科学]