腕关节镜内引流术与开放手术治疗腕关节腱鞘囊肿的比较研究  

Comparative study of wrist arthroscopy internal drainage and open surgery in the treatment of wrist ganglion cysts

作　　者：栾兆新 赵夏[2] 陈光鑫[1] 刘子祯[1] 宋海娇 汤斌[1] 黑静友[3] Luan Zhaoxin;Zhao Xia;Chen Guangxin;Liu Zizhen;Song Haijiao;Tang Bin;Hei Jingyou(Department of Hand and Foot Surgery,The Second People's Hospital of Liaocheng,Liaocheng Shandong,252600;Department of Sports Medicine,The Affiliated Hospital of Qingdao University,Qingdao Shandong,266003;Department of Joint Surgery,The Second People's Hospital of Liaocheng,Liaocheng Shandong,252600,China)

机构地区：[1]聊城市第二人民医院手足外科,山东聊城252600 [2]青岛大学附属医院运动医学科,山东青岛266003 [3]聊城市第二人民医院关节外科,山东聊城252600

出　　处：《生物骨科材料与临床研究》2024年第6期21-26,共6页Orthopaedic Biomechanics Materials and Clinical Study

基　　金：聊城市重点研发计划政策引导类项目(2023YD46)。

摘　　要：目的比较采用腕关节镜内引流技术与开放手术治疗腕关节腱鞘囊肿的疗效。方法自2017年4月至2023年1月,选取聊城市第二人民医院确诊为关节内来源腕部腱鞘囊肿拟行手术治疗的42例患者,按照随机分类法分为两组,腕关节镜组(21例)采取腕关节镜内引流技术治疗,开放手术组(21例)采取开放式手术切除。术后进行至少1年的随访,对比两组腕关节功能(PRWE评分)、腕关节疼痛程度(VAS评分)、切口瘢痕(SCAR评分)、患者对切口外观的满意度、囊肿复发及术后并发症情况。结果所有患者均获得12~36个月随访,平均(23.36±9.19)个月。根据末次随访记录结果统计分析显示,在腕关节功能上,腕关节镜组和开放手术组均表现良好[PRWE评分(7.29±2.70)分vs(8.67±2.67)分],差异无统计学意义(P>0.05);腕关节疼痛程度腕关节镜组低于开放手术组[VAS评分(1.10±1.04)分vs(2.38±1.63)分],差异有统计学意义(P<0.05);切口瘢痕增生程度腕关节镜组低于开放手术组[SCAR瘢痕美容评分(0.52±0.60)分vs(2.67±1.53)分],差异有统计学意义(P<0.05);腕关节镜组患者对切口美观满意度评分更高[(97.62±1.72)分vs(89.05±3.46)分],差异有统计学意义(P<0.05);腕关节囊肿复发率腕关节镜组低于开放手术组(4.76%vs 14.29%),差异有统计学意义(P<0.05);并发症发生率腕关节镜组低于开放手术组(0%vs 19.05%),差异有统计学意义(P<0.05)。结论腕关节镜内引流术治疗腕关节腱鞘囊肿是一种微创、有效的治疗方法,与开放手术相比,术后囊肿复发率低,并发症少,患者满意度更高,可以作为腕关节腱鞘囊肿有价值的治疗选择。Objective To compare the efficacy of wrist arthroscopy drainage technique and open surgery in the treatment of wrist ganglion cyst.Methods From April 2017 to January 2023,42 patients diagnosed with wrist ganglion cyst of intraarticular origin who were scheduled for surgical treatment in the Second People's Hospital of Liaocheng were selected and randomly divided into two groups according to the random classification method.In the arthroscopy group,21 patients underwent wrist arthroscopy drainage technology treatment,21 cases in the open surgery group underwent open surgical resection,and were followed up for at least 1 year after surgery.The wrist function score(PRWE score),wrist pain(VAS score),incision scar(SCAR score),patient satisfaction with incision appearance,cyst recurrence and postoperative complications were compared between the two groups.Results All patients were followed up for 12 to 36 months,with an average of(23.36±9.19)months.According to the statistical analysis of the last follow-up records,the wrist function in both the arthroscopy group and the open surgery group was good(PRWE score[7.29±2.70]vs[8.67±2.67]),with no significant difference(P>0.05).The degree of wrist pain in the arthroscopy group was lower than that in the open surgery group[VAS score(1.10±1.04)vs(2.38±1.63)],with a significant difference(P<0.05).The degree of incision scar hyperplasia in the arthroscopy group was lower than that in the open surgery group[SCAR Beauty Score(0.52±0.60)vs(2.67±1.53)],the difference was statistically significant(P<0.05).Patients in the arthroscopy group were more satisfied with the aesthetics of the incision after surgery[VAS score(97.62±1.72)vs(89.05±3.46)],the difference was statistically significant(P<0.05).The recurrence rate of wrist cysts in the arthroscopy group was lower than that in the open surgery group(4.76%vs 14.29%,P<0.05),the difference was statistically significant(P<0.05).The incidence of postoperative complications in the arthroscopy group was lower than that in the open

关 键 词：腕关节腱鞘囊肿 腕关节镜 内引流 手术切除 

分 类 号：R686[医药卫生—骨科学] R730.269[医药卫生—外科学]