应用PDS可吸收缝合线的改良Kessler缝合法修复手部屈指肌腱断裂  

Modified Kessler Suture Method Using PDS Absorbable Suture to Repair Flexor Tendon Rupture in the Hand

作　　者：李阿敬 陈明智 LI Ajing;CHEN Mingzhi(Department of Burns and Plastic Surgery,Affiliated Hospital of GanSu Medical College,Pingliang 744300,Gansu,China)

机构地区：[1]甘肃医学院附属医院烧伤整形科,甘肃平凉744300

出　　处：《中国美容医学》2025年第2期48-52,共5页Chinese Journal of Aesthetic Medicine

摘　　要：目的:探究应用PDS可吸收缝合线的改良Kessler缝合法修复手部屈指肌腱断裂的临床疗效。方法:回顾性分析笔者医院手外科于2020年3月-2023年3月收治的45例手部屈指肌腱断裂患者,根据治疗方法将其分为常规组和加强组,各45例。常规组实施改良Kessler缝合法治疗;加强组实施改良Kessler缝合法+PDS加强缝合治疗。比较两组患者围手术期指标(手术时间、术后恢复锻炼时间及基本康复时间)、并发症、抗拉力测试结果,术前及术后6 h、24 h、48 h的视觉疼痛评分(VAS),术后8周手功能及美学效果满意度。结果:两组患者手术时间比较差异无统计学意义(P>0.05),加强组患者术后恢复锻炼时间及基本康复时间均低于常规组(P<0.05);加强组并发症发生率、拉力测试失败率均低于常规组(P<0.05);加强组治疗后6 h、24 h及48 h的VAS评分低于常规组(P<0.05);术后8周,加强组患者各患指关节活动度均大于常规组(P<0.05);加强组美学效果满意度为93.33%,高于常规组的73.33%(P<0.05)。结论:改良Kessler缝合法+PDS加强缝合可有效修复患者手部屈指肌腱,恢复手功能,减轻疼痛感,减少并发症,美学效果满意度高,值得推广。Objective To explore the the clinical efficacy of modified kessler suture method using PDS absorbable suture to repair flexor tendon rupture in the hand.Methods The patients with hand flexor tendon rupture admitted to department of hand surgery of the author's hospital from March 2020 to March 2023 were retrospectively analyzed.According to the treatment methods,they were divided into conventional group and enhanced group,with 45 cases in each group.The conventional group was treated with modified Kessler suture,and the enhanced group was given modified Kessler+PDS enhanced suture treatment.Perioperative indicators(surgical time,postoperative recovery exercise time and basic rehabilitation time),complications,tensile resistance test result,visual analogue scale(VAS)before and at 6,24 and 48 hours after surgery and hand function at 8 weeks after surgery and cosmetic satisfaction were compared between the two groups of patients.Results There was no statistical significance in the surgical time between the two groups(P>0.05),and the postoperative recovery exercise time and basic rehabilitation time in enhanced group were shorter than those in conventional group(P<0.05).The complication rate and failure rate of tensile test in the reinforcement group were lower than those in the conventional group(P<0.05).The VAS scores in enhanced group at 6,24 and 48 hours after treatment were lower than those in conventional group(P<0.05).At 8 weeks after surgery,the ranges of motions of hand joints in enhanced group were larger than those in conventional group(P<0.05).The aesthetic satisfaction of the enhanced group was 93.33%,which was higher than 73.33%of the conventional group(P<0.05).Conclusion Modified Kessler+PDS enhanced suture can effectively repair the flexor tendon of the affected hand,restore the hand function,relieve the pain and reduce the complications,and it has high cosmetic satisfaction.

关 键 词：KESSLER缝合法 PDS缝合线 手部 屈指肌腱损伤 

分 类 号：R622[医药卫生—整形外科]