围手术期高压氧联合关节镜微创治疗运动创伤性踝关节炎49例疗效观察  

Efficacy of perioperative hyperbaric oxygen therapy combined with arthroscopic minimally invasive treatment on 49 cases of sports traumatic ankle arthritis

作　　者：周强[1] 王晖[2] 陈洪雷 王占朝[1] 何继业[2] Zhou Qiang;Wang Hui;Chen Honglei;Wang Zhanchao;He Jiye(Department of Orthopedics,Chongming Branch,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 202150,China)

机构地区：[1]上海交通大学医学院附属新华医院崇明分院骨科,上海202150 [2]上海交通大学医学院附属新华医院成人骨科

出　　处：《中华航海医学与高气压医学杂志》2020年第6期645-649,共5页Chinese Journal of Nautical Medicine and Hyperbaric Medicine

摘　　要：目的探讨围手术期高压氧(HBO)联合关节镜微创治疗运动创伤性踝关节炎(STAA)的临床疗效。方法收集2015年1月至2020年1月上海交通大学医学院附属新华医院成人骨科及上海交通大学医学院附属新华医院崇明分院骨科138例STAA患者的临床资料。按照治疗方法分为3组:常规手术治疗组(A组)46例,关节镜微创治疗组(B组)43例,HBO(术前3 d及术后第2天开始治疗)联合关节镜微创治疗组(C组)49例。观察3组患者的临床疗效,统计3组患者手术前后Mcguire踝关节功能评分(Mcguire评分)和疼痛视觉模拟评分(VAS)。记录术后踝关节功能恢复时间、术后恢复治疗时间、术后关节肿胀疼痛症状消失时间。记录手术时间、术中出血量、住院时间。结果治疗后B、C组患者较A组Mcguire评分明显增高,VAS明显降低;治疗后C组患者较B组Mcguire评分明显增高,VAS明显降低(P<0.05或P<0.01)。治疗后总有效率B组(86.0%)、C组(95.9%)明显高于A组(71.7%),C组明显高于B组,差异均有统计学意义(P<0.05或P<0.01)。B、C组患者手术时间、术中出血量和住院时间均明显短于或少于A组(P<0.05或P<0.01);C组患者住院时间明显短于B组(P<0.05),但手术时间、术中出血量比较差异无统计学意义(P>0.05)。B、C组患者术后疼痛消失时间、关节功能恢复时间及术后恢复治疗时间均明显短于A组(P<0.05或P<0.01);C组患者术后疼痛消失时间、关节功能恢复时间及术后恢复治疗时间明显短于B组,差异均有统计学意义(P<0.05)。结论HBO联合关节镜微创治疗STAA能够明显提高患者临床疗效,有利于较快恢复踝关节功能。Objective To investigate the clinical efficacy of hyperbaric oxygen(HBO)therapy combined with arthroscopic minimally invasive treatment on sports traumatic ankle arthritis(STAA)during perioperative period.Methods The clinical data of 138 patients with STAA admitted to the Department of Adult Orthopedics of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine and the Orthopedics Department of Chongming Branch of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2015 to January 2020 were collected.According to the treatment methods adopted,they were divided into 3 groups,46 cases were treated with conventional surgery(group A),43 cases were treated with arthroscopic minimally invasive treatment(group B),and 49 cases received HBO(HBO was started 3 days before the operation and restarted the second day after the operation)combined with arthroscopic minimally invasive treatment(group C).The clinical efficacies in the 3 groups of patients were observed.The Mcguire scores and the scores of visual analogue scale(VAS)for pain before and after operation were recorded.The postoperative ankle function recovery time,postoperative recovery treatment time,postoperative joint swelling and pain symptoms subsiding time,as well as the operation time,intraoperative blood loss,and length of hospital stay,were recorded.Results After treatment,the Mcguire scores of the patients in group B and C were significantly higher than those of the group A,and the VAS scores were significantly reduced;after treatment,the Mcguire scores of the patients in group C were significantly higher than that of the group B,and the VAS scores was significantly reduced,with significantly statistical differences(P<0.05,or P<0.01).After treatment,the total effective rates of the group B(86.0%)and the group C(95.9%)were significantly higher than that of the group A(71.7%),and the total effective rate of the group C was significantly higher than that of the group B,all were with significantly sta

关 键 词：围手术期 高压氧 关节镜 微创治疗 运动创伤性踝关节炎 疗效 

分 类 号：R687.4[医药卫生—骨科学]