改良小切口术结合关节镜与改良切开术治疗后交叉韧带撕脱骨折疗效对比研究  

A comparative study on the efficacy of modified small incision combined with arthroscopy and modified laparotomy in the treatment of cruciate ligament avulsion fracture

作　　者：许永超 尹二成 张峰 杨波 付军振 XU Yongchao;YIN Ercheng;ZHANG Feng;YANG Bo;FU Junzhen(Department of OrthopedicsⅡ,Hebi People's Hospital,Hebi,Henan 458030,China)

机构地区：[1]鹤壁市人民医院骨二科,河南鹤壁458030

出　　处：《社区医学杂志》2024年第20期700-705,共6页Journal Of Community Medicine

摘　　要：目的对比改良小切口术结合关节镜与改良切开术治疗后交叉韧带撕脱骨折疗效。方法选取2020-06-01-2023-06-01鹤壁市人民医院收治的160例后交叉韧带撕脱骨折患者,根据治疗方案分为切开术组80例、关节镜组80例,切开术组予以改良切开术治疗,关节镜组予以改良小切口术结合关节镜治疗;采用国际膝关节评分委员会(IKDC)评分、Lysholm评分、Tegner评分评价2组患者膝关节功能,采用酶联免疫吸附试验法检测应激指标应激水平,并利用疼痛评分量表对患者疼痛程度变化进行比较,统计并发症发生率以及评价临床疗效。计数资料采用χ^(2)检验,P<0.05为差异有统计学意义。结果手术需要时间关节镜组(93.66±9.41)min,切开术组(138.94±13.84)min;术中出血量关节镜组(142.34±14.28)mL,切开术组(242.09±24.19)mL;住院时间关节镜组(7.01±0.68)d,切开术组(14.57±1.46)d,2组比较差异有统计学意义,F值分别为24.200、31.760、41.980,均P<0.05。与切开术组Lysholm评分(63.87±6.37)分、IKDC评分(56.84±5.67)分、Tegner评分切开术组(4.08±0.39)分相比,关节镜组Lysholm评分(91.42±9.13)分、IKDC评分(94.71±9.48)分、Tegner评分(8.67±0.87)分显著升高,2组比较差异有统计学意义,F值分别为64.590、33.201、45.995,均P<0.05;与切开术组超氧化物歧化酶(62.97±6.28)kU/L、丙二醛(3.24±0.33)μmol/L相比,关节镜组超氧化物歧化酶(88.62±8.73)kU/L、丙二醛关节镜组(5.11±0.50)μmol/L显著升高,2组比较差异有统计学意义,F值分别为31.999、41.878,均P<0.05。与切开术组视觉模拟评分法(VAS)评分(8.55±0.84)分相比,关节镜组VAS评分(2.01±0.20)显著降低,2组比较差异有统计学意义,F=101.615,P<0.05。并发症发生率关节镜组为1.21%,切开术组为8.75%,2组比较差异有统计学意义,χ^(2)=4.736,P<0.05。结论改良小切口术结合关节镜治疗后交叉韧带撕脱骨折的效果优于改良切开术,适合基层开展工作,固定Objective To compare the efficacy of improved mini-incision surgery combined with arthroscopy and modified incision surgery in the treatment of posterior cruciate ligament avulsion fractures.Methods A total of 160 patients with posterior cruciate ligament avulsion fracture admitted to Hebi People's Hospital from June 1,2020 to June 1,2023,were selected and divided into an incision group(80 cases)and an arthroscopy group(80 cases)based on the treatment plan.The incision group was treated with modified incision surgery,while the arthroscopic group was treated with improved mini-incision surgery combined with arthroscopy.The knee joint function of the two groups was evaluated using the International Knee Documentation Committee(IKDC)score,Lysholm score,and Tegner score.The stress indicator levels were detected by enzyme-linked immunosorbent assay,and the pain scale was used to compare the changes in pain severity.The incidence of complications was statistically analyzed,and the clinical efficacy was evaluated.Count data were analyzed using the chi-square test,and P<0.05 was considered statistically significant.Results The operation time was(93.66±9.41)min in the arthroscopy group and(138.94±13.84)min in the incision group;the intraoperative blood loss was(142.34±14.28)ml in the arthroscopy group and(242.09±24.19)ml in the incision group;the hospital stay was(7.01±0.68)d in the arthroscopy group and(14.57±1.46)d in the incision group.The differences between the two groups were statistically significant,with F values of 24.200,31.760,and 41.980,respectively,all P<0.05.Compared with the Lysholm score(63.87±6.37),IKDC score(56.84±5.67),and Tegner score(4.08±0.39)of the incision group,the Lysholm score(91.42±9.13),IKDC score(94.71±9.48),and Tegner score(8.67±0.87)of the arthroscopy group were significantly higher,with statistically significant differences,F values of 64.590,33.201,and45.995,respectively,all P<0.05.Compared with the superoxide dismutase(62.97±6.28)kU/L and malondialdehyde(3.24±0.33)μmol/L i

关 键 词：改良小切口术 关节镜 改良切开术 后交叉韧带撕脱骨折 

分 类 号：R683.4[医药卫生—骨科学]