股内侧肌下方入路方式对全膝关节置换术患者疗效的影响分析  

Analysis of the Effect of Inferior Femoral Medialis Approach on Clinical Outcomes in Patients Undergoing Total Knee Arthroplasty

作　　者：郑文涛 闫艳强 ZHENG Wentao;YAN Yanqiang(Department of Orthopedics,Peking University Medical Zibo Hospital,Zibo 255000,China)

机构地区：[1]山东省北大医疗淄博医院骨科,山东淄博255000

出　　处：《中国伤残医学》2025年第7期1-4,9,共5页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:探讨股内侧肌下方入路对全膝关节置换术(TKA)患者手术疗效的影响。方法:回顾性分析2022年7月—2024年4月于北大医疗淄博医院行TKA手术的84例患者资料,根据入路方式不同将其分为股内侧肌组及常规组,各42例。股内侧肌组选择内侧肌下方入路方式,常规组选择髌旁内侧入路方式。比较两组手术相关指标、疼痛程度、关节活动情况及关节功能。结果:股内侧肌组的手术总用时长于常规组,切口长度短于常规组,差异均有统计学意义(P<0.05);两组的术中出血量、术后3d血红蛋白下降值比较,差异均无统计学意义(P>0.05)。术后3d,股内侧肌组的疼痛视觉模拟评分法(VAS)评分低于常规组,差异有统计学意义(P<0.05);术后6周,两组的VAS评分比较,差异无统计学意义(P>0.05)。股内侧肌组的最早抬腿时间、屈曲90°时间分别为(27.67±5.13)h、(31.60±6.09)h,均早于常规组的(34.83±5.70)h、(37.94±5.79)h,差异均有统计学意义(P<0.05);两组术后6个月的膝关节活动度比较,差异无统计学意义(P>0.05)。股内侧肌组的关节功能优良率为73.81%,与常规组的66.67%比较,差异无统计学意义(P>0.05)。结论:对TKA患者而言,不同入路方式并未对其关节功能的远期恢复效果造成明显影响,股内侧肌下方入路方式虽然会小幅增加手术时间,但早期疼痛程度更低,切口长度更短,患者关节恢复活动时间更早。Objective:To investigate the effect of inferior femoral medialis approach on patients undergoing total knee arthroplasty(TKA).Methods:Data of 84 patients who underwent TKA surgery in Peking University Medical Zibo Hospital from July 2022 to April 2024 were retrospectively analyed,and were divided into a vastus medialis muscle group and a conventional group according to different approach methods,with 42 cases in each group.The vastus medialis muscl group was treated with the inferior femoral medialis approach,while the conventional group was treated with the medial parapatellar approach.The operative indicators,pain degree,joint movement and joint function were compared between the two groups.Results:The total operation time of the vastus medialis muscle group was longer than that of the conventional group,and the incision length was shorter than that of the conventional group,the differences were statistically significant(P<0.05);there were no significant differences between the two groups in the amount of intraoperative blood loss and the decrease of hemoglobin 3 days after surgery(P>0.05).At 3 days after surgery,the Pain Visual Analogue Scale(VAS)score of the vastus medialis muscle group was lower than that of the conventional group,the difference was statistically significant(P<0.05);at 6 weeks after surgery,there was no significant difference in VAS scores between the two groups(P>0.05).The earliest leg lift time and 90°flexion time in the vastus medialis muscle group were(27.67±5.13)h and(31.60±6.09)h,respectively,which were earlier than(34.83±5.70)h and(37.94±5.79)h in the conventional group,the differences were statistically significant(P<0.05);there was no significant difference in knee joint motion 6 months after surgery between the two groups(P>0.05).The excellent and good rate of joint function in the vastus medialis muscle group was 73.81%,compared with 66.67%in conventional group,there was no significant difference(P>0.05).Conclusion:For TKA patients,different approaches have no significant imp

关 键 词：全膝关节置换术 股内侧肌入路 关节功能 膝关节活动度 

分 类 号：R687.3[医药卫生—骨科学]