导引型割刀微创治疗手指屈肌腱狭窄性腱鞘炎的疗效研究  

Effect of Minimally Invasive Treatment Using Guided Scalpel for Stenosing Tenosynovitis of Flexor Tendon of Fingers

作　　者：陈荣国[1] 曾怿 代凤雷 王鸣[3] 沈子威 姚启政 俞宁[1] CHEN Rongguo;ZENG Yi;DAI Fenglei;WANG Ming;SHEN Ziwei;YAO Qizheng;YU Ning(Department of Orthopedics,Nanjing Hospital of Traditional Chinese Medicine,Nanjing 210001,China;Department of Orthopedics,Nanjing Luhe District People's Hospital,Nanjing 210001,China;Department of Burn and Plastic Surgery,Jiangsu Provincial People's Hospital,Nanjing 210001,China;Nanjing University of Traditional Chinese Medicine,Nanjing 210001,China;Department of Traditional Chinese Medicine,Zengcheng Branch of Nanfang Hospital of Southern Medical University,Guangzhou 511300,China)

机构地区：[1]南京市中医院骨科,江苏省南京市210001 [2]南京市六合区人民医院骨三科,江苏省南京市210001 [3]江苏省人民医院烧伤整形外科,江苏省南京市210001 [4]南京市中医药大学,江苏省南京市210001 [5]南方医科大学南方医院增城分院中医科,广东省广州市511300

出　　处：《组织工程与重建外科杂志》2020年第6期494-497,共4页Journal of Tissue Engineering and Reconstructive Surgery

基　　金：南京市2018年度科技发展计划(201803021)。

摘　　要：目的探索导引型割刀微创治疗手指屈肌腱狭窄性腱鞘炎的疗效。方法选择2019年1月至2019年12月的100例(100指)手指屈肌腱狭窄性腱鞘炎患者,依据双盲法分为微创手术组(50例50指)和开放手术组(50例50指)。微创手术组采用导引型割刀对A1滑车进行微创切割松解,开放手术组采用传统开放式腱鞘切开术,对A1滑车进行切除,并对两组术后疗效进行随访。结果微创组手术时间为(4.080±0.752) min,开放手术组为(24.980±2.931) min,微创组手术时间少于开放手术组(P<0.01);两组术后切口均顺利愈合,未出现切口并发症及指固有神经、血管损伤;微创组切口愈合时间为(6.100±0.763) d,开放手术组为(13.240±0.716) d,微创组切口愈合时间短于开放手术组(P<0.01)。参照Quinnell分级标准进行疗效评定,微创组优良率达94.00%,开放手术组优良率达98.00%,差异无统计学意义(P>0.05)。结论导引型割刀微创治疗手指屈肌腱狭窄性腱鞘炎具有创伤小、手术时间短、操作简单、疗效可靠等优点,值得临床推广应用。Objective To explore the effect of minimally invasive treatment using guided scalpel on stenosing tenosynovitis of flexor tendon of fingers.Methods From January 2019 to December 2019,100 patients(100 fingers)with stenosing tenosynovitis of flexor tendon were selected.According to the double-blind method,the patients were divided into minimally invasive group(50 cases,50 fingers)and open surgery group(50 cases,50 fingers).In the minimally invasive operation group,the guided scalpel was used for minimally invasive incision and release of A1 pulley,while in the open operation group,the traditional open tenosynovectomy was used to resect the A1 pulley.The postoperative efficacy of the two groups was followed up.Results The operation time of minimally invasive group was(4.080±0.752)min,and that of open operation group was(24.980±2.931)min,and the operation time of minimally invasive group was less than that of open operation group(P<0.01).The incision healed smoothly in both groups,and there was no incision complications and collateral injury of finger proper nerve and blood vessels.The wound healing time of minimally invasive group was(6.100±0.763)d,and that of open operation group was(13.240±0.716)d,and the wound healing time in the minimally invasive group was shorter than that in the open surgery group(P<0.01).According to the quinnell classification standard,the excellent and good rate was 94%in the minimally invasive group and 98%in the open operation group.There was no significant difference between the two groups in the postoperative efficacy(P>0.05).Conclusion Compared with open operation,minimally invasive treatment using guided scalpel in treating stenosing tenosynovitis of flexor tendon has the advantages of less trauma,shorter operation time,simple operation and reliable curative effect,which is worthy of clinical application.

关 键 词：导引型割刀 微创治疗 腱鞘炎 疗效研究 

分 类 号：R687.2[医药卫生—骨科学]