关节镜下“内-外”缝合法和“全内”缝合法在膝关节外侧盘状半月板损伤治疗中的应用  

Application of inside-out suture and total internal suture under arthroscope in the treatment of discoid lateral meniscus injury

作　　者：孙鹏霄 朱庆生 方庆 段永宏 尹大宇 何明 薛刚 SUN Peng-xiao;ZHU Qing-sheng;FANG Qing;DUAN Yong-hong;YIN Da-yu;HE Ming;XUE Gang(Joint Department,Xi'an International Medical Center Hospital,Xi'an 710000,Shaanxi,CHINA)

机构地区：[1]西安国际医学中心医院关节一科,陕西西安710000

出　　处：《海南医学》2023年第24期3573-3577,共5页Hainan Medical Journal

基　　金：陕西省重点研发计划项目(编号:2022SF-491)。

摘　　要：目的比较关节镜下“内-外”缝合法和“全内”缝合法治疗膝关节外侧盘状半月板损伤的效果。方法选取2020年2月至2022年3月期间西安国际医学中心医院关节一科收治的120例膝关节外侧盘状半月板损伤患者纳入研究,按随机数表法分为内外组和全内组各60例。内外组患者使用“内-外”缝合法,全内组患者使用“全内”缝合法。比较两组患者的疗效、手术指标(包括手术时间、术时出血及住院时间)、患肢膝关节功能评分[包括Lysholm膝关节功能评分及国际膝关节评分委员会(IKDC)评分]、疼痛评分(VAS)和膝关节本体感觉差值。结果全内组患者的治疗总优良率为93.33%,明显高于内外组的78.33%,差异有统计学意义(P<0.05);全内组患者的手术时间为(37.26±8.57)min,明显短于内外组(45.87±9.32)min,差异有统计学意义(P<0.05),而两组患者术时出血量及住院时间比较差异均无统计学意义(P>0.05);全内组患者的Lysholm评分、IKDC评分分别为(87.19±7.43)分、(80.07±8.03)分,明显高于内外组的(76.77±7.39)分、(73.66±7.32)分,VAS评分为(1.25±0.23)分,明显低于内外组的(1.65±0.33)分,差异均有统计学意义(P<0.05);全内组患者15°、45°及75°膝关节本体感觉差值分别为(3.61±0.25)°、(2.93±0.36)°、(3.13±0.37)°,明显低于内外组的(3.93±0.23)°、(3.45±0.33)°、(3.68±0.31)°,差异均有统计学意义(P<0.05)。结论“全内”缝合法治疗膝关节外侧盘状半月板损伤的疗效更加确切,其能明显缩短手术时间,改善膝关节功能,降低术后疼痛感,提高膝关节感觉能力。Objective To compare the effects of inside-out suture and total internal suture under arthroscope in the treatment of discoid lateral meniscus injury.Methods A total of 120 patients with discoid lateral meniscus injury who were admitted to the Joint Department 1,Xi'an International Medical Center Hospital from February 2020 to March 2022 were included in the study.They were divided into the inside-out group(received inside-out suture)and the total internal group(received total internal suture)by random number table method,with 60 cases in each group.Curative effect,operation indicators(operation time,intraoperative blood loss,and length of hospital stay),knee function[Lysholm knee function score and International Knee Documentation Committee(IKDC)score],pain degree(Visual Analogue Scale,VAS),and knee proprioception difference were compared between the two groups.Results The excellent and good rate of treatment in the total internal group(93.33%)was significantly higher than that in the inside-out group(78.33%),and the difference was statistically significant(P<0.05).Operation time of the total internal group was significantly shorter than that of the inside-out group:(37.26±8.57)min vs(45.87±9.32)min,P<0.05.There was no statistically significant difference in intraoperative blood loss or length of hospital stay between the two groups(P>0.05).Lysholm score and IKDC score of the total internal group were(87.19±7.43)points and(80.07±8.03)points,significantly higher than(76.77±7.39)points and(73.66±7.32)points of the inside-out group;the VAS score was(1.25±0.23)points,significantly lower than(1.65±0.33)points of the inside-out group;the differences were statistically significant(P<0.05).Knee proprioception differences of the total internal group at 15°,45°,and 75°were(3.61±0.25)°,(2.93±0.36)°,and(3.13±0.37)°,significantly smaller than(3.93±0.23)°,(3.45±0.33)°,and(3.68±0.31)°in the inside-out group(P<0.05).Conclusion Total internal suture is more effective in the treatment of discoid lateral men

关 键 词：膝关节外侧盘状半月板损伤 “内-外”缝合法 “全内”缝合法 膝关节功能 疗效 

分 类 号：R684[医药卫生—骨科学]