切换至 "中华医学电子期刊资源库"

中华关节外科杂志(电子版) ›› 2020, Vol. 14 ›› Issue (02) : 226 -229. doi: 10.3877/cma.j.issn.1674-134X.2020.02.017

所属专题: 文献

临床经验

关节镜下半月板部分切除术的临床效果评价
卞荣鹏1, 朱浩1, 邹国友1,()   
  1. 1. 224002 盐城,南通大学第四附属医院骨科
  • 收稿日期:2019-08-05 出版日期:2020-04-01
  • 通信作者: 邹国友

Clinical effect evaluation of arthroscopic partial menisectomy

Rongpeng Bian1, Hao Zhu1, Guoyou Zou1,()   

  1. 1. Department of Orthopedics, the Fourth Affiliated Hospital of Nantong University, Yancheng 224002, China
  • Received:2019-08-05 Published:2020-04-01
  • Corresponding author: Guoyou Zou
  • About author:
    Corresponding author: Zou Guoyou, Email:
引用本文:

卞荣鹏, 朱浩, 邹国友. 关节镜下半月板部分切除术的临床效果评价[J/OL]. 中华关节外科杂志(电子版), 2020, 14(02): 226-229.

Rongpeng Bian, Hao Zhu, Guoyou Zou. Clinical effect evaluation of arthroscopic partial menisectomy[J/OL]. Chinese Journal of Joint Surgery(Electronic Edition), 2020, 14(02): 226-229.

目的

探究关节镜下半月板部分切除术治疗膝关节半月板损伤的临床效果。

方法

选取2017年11月至2018年11月南通大学第四附属医院骨科收治的膝关节半月板损伤患者98例,其中采用关节镜下半月板部分切除者纳入研究组(n=49),应用小切口半月板部分切除者纳入对照组(n=49)。采用t检验对比分析两组患者的手术时间、手术费用、术前术后的疼痛视觉模拟评分(VAS评分),术前术后膝关节Lysholm功能评分,采用卡方检验对比两组的临床治疗效果。

结果

研究组的治疗效果明显优于对照组(χ2=5.124,P<0.05)、两组患者术前Lysholm评分差异无统计学意义(t=1.562,P>0.05),研究组术后3 d(t=14.154,P<0.05)及术后1年(t=15.685,P<0.05)的Lysholm评分都显著高于对照组。两组患者术前疼痛评分无差异(P>0.05),术后3 d研究组患者的静息痛评分(t=13.974,P<0.05)和行走痛评分(t=13.976,P<0.05)均低于对照组,术后1年研究组患者的静息痛评分(t=14.258,P<0.05)和行走痛评分(t=14.859,P<0.05)亦显著低于对照组。对照组的手术时间短于研究组(t=8.568,P<0.05),且手术费用更低(t=3.405,P<0.05)。

结论

关节镜下半月板部分切除治疗膝关节半月板损伤的临床效果较好,且有创伤小,疼痛轻等优点,小切口半月板部分切除术的技术难度较低,亦可在临床中选择性采用。

Objective

To investigate the clinical effect of arthroscopic partial menisectomy in the treatment of knee meniscus injury.

Methods

From November 2017 to November 2018, 98 patients with knee meniscus injury treated in the Department of Orthopedics, the Fourth Affiliated Hospital of Nantong University were collected. Patients in the control group were treated with open meniscectomy (n=49). Patients in the study group were treated with arthroscopic partial menisectomy (n=49). The operation time, cost, visual analogue score(VAS) of preoperative and postoperative pain, preoperative and postoperative Lysholm function score of the knee joint was compared and analyzed by t test. The clinical treatment effect of the two groups was compared by chi-square test.

Results

The treatment effect of the study group was significantly better than that of the control group (χ2=5.124, P <0.05). There was no significant difference in Lysholm scores between the two groups before surgery (t=1.562, P>0.05). The Lysholm score of the study group was significantly higher than that of the control group three days (t=14.154, P <0.05) and one year (t=15.685, P <0.05) after the surgery. There was no difference in the preoperative pain score of two groups (P> 0.05). The resting pain score (t =13.974, P <0.05) and walk pain score (t=13.976, P <0.05) in three days after surgey of the study group were lower than the control group, and the resting pain score (t=14.258, P <0.05) and walk pain score (t=14.859, P <0.05) one year after surgery of the study group were significantly lower than the control group. The operation time of the control group was shorter than the study group (t=8.568, P <0.05), and the operation cost was lower (t=3.405, P <0.05).

Conclusion

Arthroscopic partial menisectomy for meniscus injury has a good clinical effect, and has the advantages of less trauma and less pain, while modified open meniscectomy is easier in technique and can be used selectively in clinic.

表1 两组患者手术1年后治疗效果的对比[例,(%)]
表2 两组患者治疗前后膝关节功能Lysholm评分对比[分,(±s)]
表3 两组患者手术前后疼痛评分对比[分,(±s)]
[1]
Clayton RA, Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries[J]. Injury, 2008,39(12): 1338-1344.
[2]
Kim JG, Lee YS, Bae TS, et al. Tibiofemoral contact mechanics following posterior root of medial meniscus tear, repair, meniscectomy, and allograft transplantation[J]. Knee Surg Sports Traumatol Arthrosc, 2013. 21(9): 2121-2125.
[3]
Hamberg P, Gillquist J, Lysholm J. A comparison between arthroscopic meniscectomy and modified open meniscectomy. A prospective randomised study with emphasis on postoperative rehabilitation[J]. J Bone Joint Surg Br, 1984. 66(2): 189-192.
[4]
Giwa SO. Arthroscopic menisectomy[J]. J West Afr Coll Surg, 2017, 7(1): 10-13.
[5]
郑鸿,谭宏昌,康毅,等.关节镜下两种手术方式治疗盘状半月板损伤的临床疗效对比[J/CD].中华关节外科杂志(电子版),2018,12(4): 484-489.
[6]
Jeong HJ, Lee SH, Ko CS. Meniscectomy[J]. Knee Surg Relat Res, 2012, 24(3): 129-136.
[7]
Henning CE, Clark JR, Lynch MA, et al. Arthroscopic meniscus repair with a posterior incision[J]. Instr Course Lect, 1988, 37: 209-221.
[8]
Paxton ES, Stock MV, Brophy RH. Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes[J]. Arthroscopy, 2011, 27(9): 1275-1288.
[9]
Biedert RM. Treatment of intrasubstance meniscal lesions: a randomized prospective study of four different methods[J]. Knee Surg Sports Traumatol Arthrosc, 2000, 8(2): 104-108.
[10]
Tapper EM, Hoover NW. Late results after meniscectomy[J]. J Bone Joint Surg Am, 1969, 51(3): 517-526.
[11]
Hede A, Hejgaard N, Larsen E, et al. Partial or total open meniscectomy? A prospective, randomized study[J].Int Orthop, 1986, 10(2): 105-108.
[12]
Northmore-Ball MD, Dandy DJ, Jackson RW. Arthroscopic, open partial, and total meniscectomy. A comparative study[J]. J Bone Joint Surg Br, 1983, 65(4): 400-404.
[13]
El Ghazaly SA, Rahman AA, Yusry AH, et al. Arthroscopic partial meniscectomy is superior to physical rehabilitation in the management of symptomatic unstable meniscal tears[J]. Int Orthop, 2015, 39(4): 769-775.
[1] 纪小孟, 刘璠, 唐晓波, 卞为伟, 董佩龙, 刘振鲁. 两种手术方式治疗肩袖撕裂合并粘连性肩关节囊炎[J/OL]. 中华关节外科杂志(电子版), 2024, 18(05): 561-567.
[2] 张舒沁, 陈练. 产后宫腔内妊娠物残留的诊断和临床处理[J/OL]. 中华妇幼临床医学杂志(电子版), 2024, 20(05): 493-497.
[3] 李友, 唐林峰, 杜伟伟, 刘海亮, 余新水, 沈佳宇, 巨积辉. 皮瓣联合掌长肌腱折叠单排三点式固定治疗指背侧创面伴锤状指畸形的临床效果观察[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(06): 485-490.
[4] 王典, 刘双赫, 曾峥. 肩关节镜术后肌肉功能改变对颈椎形态及矢状面参数影响的自身前后对照队列研究[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 371-378.
[5] 王强, 金光哲, 巨积辉, 王凯, 唐晓强, 吕文涛, 程贺云, 杨林, 王海龙. 超声辅助定位下游离臂内侧皮瓣在修复手指创面中的临床应用[J/OL]. 中华损伤与修复杂志(电子版), 2024, 19(05): 393-397.
[6] 刘敏, 唐恩溢, 刘喆, 葛苏蒙, 刘梅, 孙国文. 计算机导航技术在口腔颌面部微小异物取出手术中的应用[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 375-379.
[7] 宋玟焱, 杜美君, 陈佳丽, 石冰, 黄汉尧. 唇腭裂手术围手术期疼痛管理的研究进展及基于生物材料治疗新方法的展望[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(06): 397-405.
[8] 孙莲, 马红萍, 吴文英. 局部进展期甲状腺癌患者外科处理[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(01): 112-114.
[9] 杜伟, 廖土明, 李雄才, 关刚强, 何燊, 吴佳桥, 朱和荣. 2%利多卡因凝胶和润滑剂凝胶在女性尿流动力学检查中应用的随机对照研究[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(06): 613-617.
[10] 闫亚飞, 范学圣, 张舰, 吴勇. 经腹腹膜前疝修补术治疗复发腹股沟疝的临床效果[J/OL]. 中华疝和腹壁外科杂志(电子版), 2024, 18(05): 552-556.
[11] 赵毅, 李昶田, 唐文博, 白雪婷, 刘荣. 腹腔镜术中超声主胰管自动识别模型的临床应用[J/OL]. 中华腔镜外科杂志(电子版), 2024, 17(05): 290-294.
[12] 刘卓, 张宗明, 张翀, 刘立民, 赵月, 齐晖. 腹腔镜手术治疗高龄急性梗阻性化脓性胆管炎患者的安全性与术式选择[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 795-800.
[13] 陈宗杰, 胡添松. 肝外伤破裂患者治疗后胆漏发生影响因素分析[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13(06): 836-840.
[14] 韦巧玲, 黄妍, 赵昌, 宋庆峰, 陈祖毅, 黄莹, 蒙嫦, 黄靖. 肝癌微波消融术后中重度疼痛风险预测列线图模型构建及验证[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 715-721.
[15] 蔡晓雯, 李慧景, 丘婕, 杨翼帆, 吴素贤, 林玉彤, 何秋娜. 肝癌患者肝动脉化疗栓塞术后疼痛风险预测模型的构建及验证[J/OL]. 中华临床医师杂志(电子版), 2024, 18(08): 722-728.
阅读次数
全文


摘要