充气式止血带对关节镜下半月板成形缝合术后康复影响的研究  

Study on the influence of inflatable tourniquet on postoperative rehabilitation of meniscoplasty and suture surgery under arthroscopy

作　　者：刘长杰 刘晓光[2] 孙泉祥 李娜[2] 付道通 刘泽众 张益民[2] LIU Chang-jie;LIU Xiao-guang;SUN Quan-xiang(School of Clinical Medicine,Weifang Medical University,Weifang 261000,China;不详)

机构地区：[1]潍坊医学院临床医学院潍坊医学院,山东潍坊261000 [2]潍坊医学院第一附属医院关节外科,山东潍坊261000

出　　处：《中国医学装备》2023年第12期111-115,共5页China Medical Equipment

基　　金：山东省自然科学基金面上项目(ZR2020MH094)“sestrin2及其相关的内质网应激对膝骨性关节炎的调控作用及机制研究”。

摘　　要：目的:探讨使用充气式止血带对膝关节镜下半月板缝合修复术后疼痛、肌肉损伤、半月板愈合情况及功能康复的影响。方法:选取医院收治的144例行膝关节半月板缝合修复手术的患者,根据是否使用止血带分为止血带组(81例)和非止血带组(63例),根据患者术后血清肌酸激酶(CK)评估术后肌肉损伤情况,采用视觉模拟量表(VAS)评估患者术后的疼痛情况,采用国际膝关节文献委员会(IKDC)评分系统、Lysholm膝关节评分以及Tegner膝关节评分系统评估患者术后膝关节功能康复效果,按照Barrett标准评价半月板缝合术后的临床愈合情况。结果:两组患者术前、术后2 d、术后8 d及末次随访的CK水平比较,差异均无统计学意义(t=1.667,t=-2.143,t=-4.461,t=-6.380;P>0.05)。两组患者术前、术后2 d、术后8 d及末次随访的VAS评分比较,差异均无统计学意义(Z=-1.121,Z=-1.364,Z=0.745,Z=-0.894;P>0.05)。两组患者手术前后IKDC评分及Lysholm评分比较,差异均无统计学意义(tIKDC=-1.680,t=0.533;tLyshlom=-3.162,t=-2.543;P>0.05)。两组患者手术前及末次随访Tegner评分比较,差异无统计学意义(Z=-0.803,Z=-0.370;P>0.05),两组患者术后半月板愈合率比较,差异无统计学意义(Z=-0.247,P>0.05)。结论:在关节镜下半月板缝合术中使用止血带,不会导致肌肉的损伤,不增加患者疼痛,不影响患者半月板愈合率及功能康复。Objective:To investigate the influence of using tourniquet on the postoperative pain,the muscle injury,the meniscal healing and the rehabilitation of meniscus function after surgery of meniscus suture and repair under arthroscopy.Methods:A total of 144 patients who underwent surgery of suture and repair for meniscus of knee joint in hospital were selected and they were divided into tourniquet group(81 cases)and non-tourniquet group(63 cases)according to whether used tourniquet.Postoperative muscle injury was assessed according to postoperative serum creatine kinase(CK),and postoperative pain was assessed by using visual analogue scale(VAS).The international k nee documentation committee(IKDC)scoring system,Lysholm knee joint score and Tegner knee joint score system were used to assess the rehabilitation effect of the function of knee joint of patient after surgery,and the clinical healing after the surgery of meniscus suture was evaluated according to Barrett standard.Results:There were no significant differences in CK levels between the two groups before surgery,2 days and 8 days after surgery,and at the last follow-up(t=1.667,t=-2.143,t=-4.461,t=-6.380,P>0.05),respectively.There were no significant differences in VAS scores between the two groups before surgery,2 days and 8 days after surgery,and at the last follow-up(Z=-1.121,Z=-1.364,Z=0.745,Z=-0.894,P>0.05),respectively.There were no significant differences in IKDC scores and Lysholm scores before and after surgery between the two groups(tIKDC=-1.680,t=0.533,tLysholm=-3.162,t=-2.543,P>0.05),respectively.There were no significant differences in Tegner score before and after operation between the two groups(Z=-0.803,Z=-0.370,P>0.05),respectively.There was no significant difference in the healing rate of meniscus after surgery between the two groups(Z=-0.247,P>0.05).Conclusion:The use of tourniquet in the surgery of meniscus suture under arthroscopy would not cause muscle injury,and would not aggravate pain,and does not affect healing rate and rehabilitation of

关 键 词：关节镜 止血带 半月板修复 VAS评分 Barrett标准 

分 类 号：R197.39[医药卫生—卫生事业管理]