关节镜下骨赘磨削联合带线可吸收锚钉修复治疗股骨髋臼撞击症伴盂唇损伤的疗效与安全性分析  

Arthroscopic osteophyte grinding combined with suture absorbable anchor screw repair for treatment of femoral acetabular impaction with glenoid lip injury

作　　者：张伟 陈洪 彭超 张新虎 Zhang Wei;Chen Hong;Peng Chao;Zhang Xinhu(Joint Orthopedics&Sports Medicine Ward,Hengshui People’s Hospital,Hebei Province,Hengshui 053000,China)

机构地区：[1]河北省衡水市人民医院关节运动医学病区,053000

出　　处：《疑难病杂志》2023年第2期193-198,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省2021年度医学科学研究课题计划(20210322)。

摘　　要：目的观察关节镜下骨赘磨削联合带线可吸收锚钉修复治疗股骨髋臼撞击症伴盂唇损伤的疗效与安全性。方法选取2018年2月—2020年2月河北省衡水市人民医院关节运动医学病区收治股骨髋臼撞击症伴盂唇损伤患者70例,按照随机数字表法分为对照组、观察组,各35例。对照组给予关节镜下骨赘磨削盂唇成形术治疗,观察组给予关节镜下骨赘磨削联合带线可吸收锚钉修复治疗。比较2组手术、并发症发生情况,手术前后创伤应激指标[皮质醇(Cor)、促肾上腺皮质激素(ACTH)、C反应蛋白(CRP)]、髋关节功能(改良Harris评分)、疼痛度[视觉模拟量表(VAS)评分]、髋关节活动度,以及患者对疗效满意度。结果观察组手术时间长于对照组(t/P=3.594/0.001);2组术前及术后1、3、7 d血清Cor、ACTH、CRP水平呈先升高后下降趋势(P<0.01),且观察组术后1、3、7 d血清Cor、ACTH、CRP水平低于对照组(P<0.01);2组术后3个月、6个月、1年、2年改良Harris评分呈升高趋势,VAS评分呈下降趋势(P<0.01),且观察组改善程度明显优于对照组(P<0.001);2组术后3个月、6个月、1年、2年髋关节屈曲、内旋、外展活动度呈升高趋势(P<0.01),且观察组升高幅度高于对照组(P<0.001);观察组患者疗效满意度高于对照组(χ^(2)/P=4.861/0.028);观察组并发症发生率略低于对照组,但差异无统计学意义(χ^(2)/P=1.790/0.181)。结论关节镜下骨赘磨削联合带线可吸收锚钉修复治疗股骨髋臼撞击症伴盂唇损伤患者,可促进髋关节功能恢复,减轻疼痛度,改善创伤应激反应,降低并发症发生率,提高患者治疗满意度。Objective To observe the efficacy and safety of arthroscopic osteophyte grinding combined with suture absorbable anchor screw repair in the treatment of femoral acetabular impaction with glenoid lip injury.Methods Seventy patients with femoral acetabulum impaction and glenoid lip injury were selected from the joint sports medical ward of Hengshui People's Hospital of Hebei Province from February 2018 to February 2020.They were divided into control group and observation group according to the method of random number table,with 35 patients in each group.The control group was treated with arthroscopic osteophyte grinding and glenoplasty,while the observation group was treated with arthroscopic osteophyte grinding and suture absorbable anchor nail repair.The occurrence of surgery and complications,trauma stress index[cortisol(Cor),adrenocorticotropic hormone(ACTH),C-reactive protein(CRP)],hip joint function(modified Harris score),pain degree(VAS score),hip joint range of motion before and after surgery were compared between the two groups,as well as patients'satisfaction with curative effect.Results The operation time in the observation group was longer than that in the control group(t/P=3.594/0.001).The levels of serum Cor,ACTH and CRP in the two groups increased first and then decreased on the 1st,3rd and 7th day after operation(P<0.01),and the levels of serum Cor,ACTH and CRP in the observation group were lower than those in the control group on the 1st,3rd and 7th day after operation(P<0.01).The modified Harris score of the two groups showed an upward trend at 3 months,6 months,1 year and 2 years after operation,while the VAS score showed a downward trend(P<0.01),and the improvement degree of the observation group was significantly better than that of the control group(P<0.001).The flexion,pronation and abduction of the hip joint in the two groups showed an increasing trend at 3 months,6 months,1 year and 2 years after operation(P<0.01),and the increase in the observation group was higher than that in the control

关 键 词：股骨髋臼撞击症 盂唇损伤 骨赘磨削 带线可吸收锚钉 关节镜 创伤应激 髋关节功能 

分 类 号：R684[医药卫生—骨科学]