囊肿位置分型指导下的关节镜下双后内入路腘窝部位囊肿切除术  

Arthroscopic popliteal cyst resection by double posterior interior approach under the guidance of classification of cyst location

作　　者：赵文斌[1] 凃峰[1] 张麟 吕龙 王皓[1] 张晨[1] ZHAO Wen-bin;TU Feng;ZHANG Lin;LYU Long;WANG Hao;ZHANG Chen(Department of Orthopaedics,Wuhan No.1 Hospital,Wuhan 430022,China)

机构地区：[1]武汉市第一医院骨关节科,武汉430022

出　　处：《骨科》2021年第2期155-160,共6页ORTHOPAEDICS

摘　　要：目的依据腘窝部位囊肿的不同位置制定相应的手术方案,观察手术临床疗效。方法根据腘窝部位囊肿位置的不同将其分为3种类型:A型,囊肿位于腓肠肌内侧头的内侧;B型,囊肿包绕腓肠肌内侧头的内外两侧;C型,囊肿位于腘窝神经血管束的外侧。回顾性分析我院2018年6月至2019年6月收治的27例腘窝部位囊肿病人的临床资料,其中男12例,女15例,年龄为(34.8±12)岁(18~65岁)。A型22例,B型4例,C型1例。A型采用关节镜下双后内入路活瓣切除+囊壁切除手术;B型采用关节镜下双后内入路活瓣切除+有限囊壁切除手术;C型采用开放手术治疗。采用Rauschning-Lindgren标准评价病人术后的临床疗效。结果病人均获得随访,随访时间为(9.0±3.2)个月(6~18个月)。病人均无明显不良反应以及囊肿复发。末次随访时Rauschning-Lindgren标准为0~1级。结论腘窝部位囊肿根据位置进行分型后,可以一定程度上避免手术并发症以及囊肿复发,帮助提高手术安全性与手术成功率。Objective To coin a kind of classification by popliteal cystlocation which can help to make corresponding surgical plan,and observe the clinical curative effect.Methods In this study,the popliteal cyst was classified into three main types according to its location:for type A,the cyst was located on the medial head of gastrocnemius muscle;for type B,the cyst encysted the medial and lateral sides of the medial head of the gastrocnemius muscle;for type C,the cyst was located on the lateral side of the popliteal neurovascular bundle.From June 2018 to June 2019,27 patients with popliteal cysts were admitted to our hospital,including 12 males and 15 females aged(34.8±12)years(18-65 years).There were 22 cases of type A,4 cases of type B,and 1 case of type C.Type A was treated with double posterior approach arthroscopic valvular mechanism resection and cystectomy.Type B was treated with double posterior approach arthroscopic valvular mechanism resection and partial cystectomy.Type C was treated with open surgery.The clinical efficacy was observed according to the Rauschning-Lindgren criteria evaluation.Results All patients were followed up for(9.0±3.2)months(6-18 months).All patients had no significant complications and cyst recurrence during the follow-up period,and at the last follow-up the Rauschning-Lindgren criteria were 0-1 grade.Conclusion After the classification according to the location,we can effectively avoid the surgical complications and cyst recurrence,and help to improve the surgical safety and success rate.

关 键 词：腘窝部位囊肿 关节镜 双后内入路 囊肿位置 分型 

分 类 号：R687.4[医药卫生—骨科学]