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中华关节外科杂志(电子版)

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:
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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]. 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]. 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。

关键词: 关节镜, 外科手术, 微创性, 半月板, 创伤和损伤, 有效性研究, 疼痛
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.

Key words: Arthroscope, Surgical procedures, minimally invasive, Menisci, Wounds and injuries, Validation studies, Pain
表1 两组患者手术1年后治疗效果的对比[例，(%)]
组别 例数 显效 有效 无效 有效率
对照组 49 13(26.5) 20(40.8) 16(32.7) 67.3%
研究组 49 19(38.8) 26(53.1) 4(8.1) 91.9%
χ2值   4.685 4.983 5.368 5.124
P值   <0.05 <0.05 <0.05 <0.05
表2 两组患者治疗前后膝关节功能Lysholm评分对比[分，(±s)]
组别 例数 术前 术后3 d 术后1年
对照组 49 61±8 65±6 74±8
研究组 49 60±7 69±6 86±8
t值   1.562 14.154 15.685
P值   >0.05 <0.05 <0.05
表3 两组患者手术前后疼痛评分对比[分，(±s)]
组别 例数 静息痛评分 行走痛评分
术前 术后3 d 术后1年 术前 术后3 d 术后1年
对照组 49 3.1±1.8 2.9±1.7 2.0±1.6 5.1±1.9 4.5±1.7 2.9±1.8
研究组 49 3.2±1.9 2.5±1.8 1.4±1.5 5.2±1.6 4.0±1.4 1.8±1.9
t值   1.524 13.974 14.258 1.212 13.976 14.859
P值   >0.05 <0.05 <0.05 >0.05 <0.05 <0.05
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