显微手术修复治疗屈指肌腱损伤效果及其对关节活动度和手功能影响  

Microsurgical repair for flexor tendon injury and its impact on joint range of motion and hand function

作　　者：闫新涛 郭宁国[1] 赵振举 王振江[1] YAN Xintao;GUO Ningguo;ZHAO Zhenju;WANG Zhenjiang(Department of Hand and Foot Surgery,Puyang Oilfield General Hospital,Puyang 457001,China)

机构地区：[1]濮阳市油田总医院手足外科,河南濮阳457001

出　　处：《社区医学杂志》2023年第17期885-889,共5页Journal Of Community Medicine

摘　　要：目的 观察显微手术治疗屈指肌腱损伤效果及其对关节活动度和手功能影响,探讨显微手术修复应用价值。方法 选取2020-08-10-2022-08-31濮阳市油田总医院收治的84例屈指肌腱损伤患者为研究对象,按随机数字表法分成A组、B组,各42例。B组接受传统手术修复治疗,A组接受显微手术修复治疗。对比2组手术效果、手术前后腕关节活动度、伤指总活动度(TAM)、血清前列腺素E2(PGE2)、超氧化物歧化酶(SOD)、丙二醛(MDA)、P物质(SP)含量及并发症发生率。结果 A组手术优良率为92.86%(39/42),与B组的76.19%(32/42)相比更高,χ^(2)=4.459,P=0.035。A组术后1个月背伸、桡偏、掌屈、尺偏活动度分别为(41.34±4.57)°、(18.46±2.18)°、(47.53±5.14)°、(26.48±3.40)°,术后3个月分别为(48.33±5.26)°、(24.75±2.35)°、(55.20±5.78)°、(32.12±4.31)°,均高于B组术后1个月的(30.06±3.49)°、(13.82±1.72)°、(39.89±4.16)°、(22.64±3.06)°,术后3个月的(37.40±3.78)°、(16.80±1.91)°、(46.54±4.62)°、(27.93±3.54)°,F组间分别为13.592、14.259、12.541和10.351,均P<0.001;A组术后1个月小指、环指、中指、食指、拇指TAM分别为(131.51±8.74)°、(133.49±8.46)°、(139.85±10.49)°、(137.97±9.31)°、(139.35±10.72)°,术后3个月分别为(156.14±9.03)°、(158.68±9.02)°、(159.46±10.70)°、(166.37±11.22)°、(168.08±11.24)°,均高于B组术后1个月的(120.60±7.85)°、(121.17±7.69)°、(125.31±8.81)°、(128.03±8.38)°、(122.68±8.11)°,术后3个月的(135.53±8.19)°、(138.41±8.25)°、(141.59±9.73)°、(145.52±9.34)°、(146.86±10.95)°,F组间分别为13.675、14.185、13.391、14.174和13.892,均P<0.001。A组术后1 d血清PGE2、MDA、SP水平分别为(59.41±5.26)μg/L、(9.32±1.01)μmol/L、(9.22±1.87) pmol/L,术后3 d分别为(52.15±4.53)μg/L、(7.05±0.86)μmol/L、(8.06±1.25) pmol/L,均低于B组术后1 d的(65.73±6.17)μg/L、(14.85±1.57)μmol/L、(13.15±1.59) pmol/L,术后3 d的(58.77±4.86)μgObjective To observe the effect of microsurgery on the treatment of flexor tendon injury and its impact on joint mobility and hand function,and to explore the application value of microsurgery repair.Methods Totally 84patients with flexor tendon injuries admitted to Puyang Oilfield General Hospital from August 10,2020to August 31,2022were selected as the research subjects,and divided into group A(n=42)and group B(n=42)according to the random number table method.Group B received conventional surgical repair treatment and Group A received microsurgical repair treat-ment.The operation effect,wrist joint activity,total activity of injured fingers(TAM),serum prostaglandin E 2(PGE 2),superoxide dismutase(SOD),malondialdehyde(MDA),substance P(SP)and the incidence of complications were com-pared between the two groups.Results The surgical excellence rate was 92.86%(39/42)in Group A higher than Group B at 76.19%(32/42),χ^(2)=4.459,P=0.035.The dorsal extension,radial deviation,palmar flexion and ulnar deviation mobility in Group A were(41.34±4.57)°,(18.46±2.18)°,(47.53±5.14)°and(26.48±3.40)°at 1month postoperatively,espectively;and were(48.33±5.26)°,(24.75±2.35)°,(55.20±5.78)°,(32.12±4.31)°at 3months post-operative-ly,respectively,all higher than(30.06±3.49)°,(13.82±1.72)°,(39.89±4.16)°,(22.64±3.06)°at 1month post-operatively in Group B,and(37.40±3.78)°,(16.80±1.91)°,(46.54±4.62)°,(27.93±3.54)°at 3months postoper-atively(F intergroup were 13.592,14.259,12.541,10.351,all P<0.001).The TAM of the little finger,ring finger,middle finger,index finger,and thumb in Group A were(131.51±8.74)°,(133.49±8.46)°,(139.85±10.49)°,(137.97±9.31)°,and(139.35±10.72)°at 1 month postoperatively and(156.14±9.03)°,(158.68±9.02)°,(159.46±10.70)°,(166.37±11.22)°,(168.08±11.24)°,respectively,at 3months postoperatively,which were high-er than those in Group B(120.60±7.85)°,(121.17±7.69)°,(125.31±8.81)°,(128.03±8.38)°,(122.68±8.11)°at 1month postoperatively,and(135.53±8.19)°,(138.41±8.

关 键 词：显微手术 屈指肌腱损伤 手功能 创伤反应 

分 类 号：R687.2[医药卫生—骨科学]