改良Sauvé-Kapandji术治疗类风湿性桡尺远侧关节炎的疗效分析  

Clinical efficacy of the modified Sauvé-Kapandji procedure for the treatment of rheumatoid arthritis of distal radioulnar joint

作　　者：尹善青[1] 黄耀鹏[1] 潘佳栋[1] 丁文全[1] 李学渊[1] 王欣[1] Yin Shanqing;Huang Yaopeng;Pan Jiadong;Ding Wenquan;Li Xueyuan;Wang Xin(Department of Hand Surgery,Ningbo No.6 Hospital,Ningbo 315000,China)

机构地区：[1]宁波市第六医院手外科,宁波315000

出　　处：《中华手外科杂志》2022年第1期44-47,共4页Chinese Journal of Hand Surgery

摘　　要：目的探讨应用改良Sauvé-Kapandji术治疗类风湿性烧尺远侧关节(distal radioulnar joint,DRUJ)关节炎的临床效果。方法自2012年4月至2016年4月我们共收治18例类风湿导致的DRUJ关节炎患者,采用改良Sauvé-Kapandji术治疗,术后随访对患者腕关节疼痛情况应用疼痛视觉模拟评分(visual analogue scale,VAS)进行评估,腕关节功能记录包括腕关节的屈伸、前臂的旋前旋后活动度,应用Mayo评分系统进行总功能评估。结果术后所有患者均获得随访,时间为1.5〜5.5年,平均3.5年,未发生尺骨残端不稳定;疼痛由术前平均(6.5±2.5)分改善至术后(2.4±2.1)分,握力由术前(4.5±4.3)kg增加至术后(7.5±3.5)kg,前臂旋后活动度由术前(61±16)。改善至术后(81±13)°,腕关节总功能评价采用Mayo评分由术前平均(46.2±11.4)分恢复至术后(68.5±10.8)分,术后各项指标与术前比较差异均有统计学意义(P<0.05)。结论应用改良Sauvé-Kapandji术治疗类风湿性桡尺远侧关节炎可以稳定尺骨残端,防止腕关节不稳,明显缓解腕关节疼痛,手部握力及前臂旋后活动度得到有效改善,术后疗效满意。Objective To investigate the clinical efficacy of the modified Sauv^-Kapandji procedure for the treatment of rheumatoid arthritis of distal radioulnar joint(DRUJ).Methods From April 2012 to April 2016,18 patients with DRUJ arthritis caused by rheumatoid arthritis were treated with modified Sauv6-Kapandji procedure.The wrist pain of the patients was evaluated by visual analogue scale(VAS).The functional records of the wrist joint included the flexion and extension of the wrist joint and the pronation and supination of the forearm.The Mayo scoring system was used for total functional evaluation.Results All the patients were follow-up for 1.5 to 5.5 years,with an average of 3.5 years.No ulnar stump instability occurred.The pain improved from an average of(6.5±2.5)points before operation to(2.4±2.1)points after operation,the grip strength increased from(4.5±4.3)kg before operation to(7.5±3.5)kg after operation,the supination range of forearm improved from(61±16)0 before operation to(81±13)°after operation,and the Mayo score was used to evaluate the total wrist function,which recovered from an average of(46.2±11.4)points before operation to(68.5±10.8)points after operation.There were significant differences in postoperative indexes compared with those before operation(P<0.05).Conclusion The modified Sauv^-Kapandji procedure in the treatment of rheumatoid arthritis of DRUJ can stabilize the ulnar stump,prevent wrist instability,significantly alleviate wrist pain,effectively improve hand grip strength and forearm supination movement,and the postoperative clinical efficacy is satisfactory.

关 键 词：关节炎 类风湿 治疗结果 改良Sauvé-Kapandji术 桡尺远侧关节 

分 类 号：R687.4[医药卫生—骨科学]