类“Pie-crusting”辅助关节镜与开放手术治疗小儿Ⅲ度臀肌挛缩症疗效对比  

To compare the efficacy of Pie-crusting assisted arthroscopy and open surgery in the treatment of gluteal muscle contracture(degree Ⅲ)in children

作　　者：张荐[1] 王斌[2] 赵洪波[1] 王月光[3] 周宏艳[3] 孙明宏 张德新[1] ZHANG Jian;WANG Bin;ZHAO Hong-bo;WANG Yue-guang;ZHOU Hong-yan;SUN Ming-hong;ZHANG De-xin(Department 3 of Arthrology,The Second Hospital of Tangshan,Tangshan,Hebei,063000,China)

机构地区：[1]唐山市第二医院关节3科,河北省063000 [2]唐山市第二医院手1科,河北省063000 [3]唐山市第二医院小儿骨2科,河北省063000

出　　处：《中国骨与关节杂志》2025年第3期228-232,共5页Chinese Journal of Bone and Joint

摘　　要：目的比较类“Pie-crusting”辅助关节镜与开放手术治疗小儿Ⅲ度臀肌挛缩症的临床疗效。方法2016年8月至2022年6月,唐山市第二医院小儿骨科收治26例(52侧)Ⅲ度注射性臀肌挛缩症患儿,其中男12例,女14例;年龄8~16岁,平均12.1岁。34侧行类“Pie-crusting”辅助关节镜微创治疗(观察组),18侧行开放手术治疗(对照组)。比较两组手术切口长度、手术耗时、术中出血量、术后住院时间,并以术后步态、并膝下蹲、交腿试验、弹跳感等综合评价疗效。结果26例(52侧)均获随访,随访时间6~36个月,平均13个月。手术切口长度:观察组(1.0±0.3)cm,对照组(10.4±2.6)cm,差异有统计学意义(P<0.05);手术耗时:观察组(92.4±31.9)min,对照组(98.2±41.1)min,差异无统计学意义(P>0.05);术中出血量:观察组(35.2±14.1)ml,对照组(118.2±49.1)ml,差异有统计学意义(P<0.05);术后住院时间:观察组(3.3±1.6)天,对照组(6.0±1.8)天,差异有统计学意义(P<0.05)。两组病例切口均Ⅰ期愈合,均无神经、血管损伤发生。末次随访以两组术后步态、并膝下蹲、交腿试验、弹跳感等综合疗效为评价标准:观察组优31侧,良2侧,差1侧;对照组优16侧,良1侧,差1侧,差异无统计学意义(P>0.05)。结论类“Pie-crusting”辅助关节镜微创与开放手术治疗小儿Ⅲ度臀肌挛缩临床疗效均可靠,但类“Pie-crusting”辅助关节镜治疗臀肌挛缩具有创伤小、出血少、恢复快等优点,容易被患儿(尤其是女性)所接受。Objective To compare the clinical efficacy of“Pie-crusting”-assisted arthroscopy and open surgery in the treatment of gradeⅢgluteal muscle contracture in children.Methods From August 2016 to June 2022,26 children(52 affected sides)with gradeⅢinjection-induced gluteal muscle contracture were admitted to the Department of Pediatric Orthopedics of Tangshan Second Hospital.Among them,there were 12 boys and14 girls with an average age of 12.1 years(range:8 to 16 years).Minimally invasive treatment with“Pie-crusting”-assisted arthroscopy was performed on 34 sides(observation group),and open surgery was performed on 18 sides(control group).The length of the surgical incision,the duration of the operation,the intraoperative blood loss,and the postoperative hospital stay were compared between the two groups.The curative effect was comprehensively evaluated by postoperative gait,squatting with knees,crossed-leg test,and bouncing sensation.Results All 26 children(52 affected sides)were followed up for 6 to 36 months,with an average of 13 months.The length of the surgical incision was(1.0±0.3)cm in the observation group and(10.4±2.6)cm in the control group,and the differences were statistically significant(P<0.05).The duration of the operation was(92.4±31.9)minutes in the observation group and(98.2±41.1)minutes in the control group,and there was no statistically significant difference(P>0.05).The intraoperative blood loss was(35.2±14.1)ml in the observation group and(118.2±49.1)ml in the control group,and the differences were statistically significant(P<0.05).The postoperative hospital stay was(3.3±1.6)days in the observation group and(6.0±1.8)days in the control group,and the differences were statistically significant(P<0.05).The incisions of both groups healed by first intention,and there was no occurrence of nerve or blood vessel injury.At the last follow-up,the comprehensive curative effect was evaluated according to the postoperative gait,squatting with knees,crossed-leg test,and bouncing sensation.I

关 键 词：关节镜 儿童 挛缩 臀肌 

分 类 号：R685[医药卫生—骨科学]