發(fā)布時間：2018-06-05 20:49

  本文選題：跟腱斷裂 + 力學生物學��； 參考：《新疆醫(yī)科大學》2017年碩士論文

【摘要】：目的:比較經(jīng)皮Yurt-bone縫合與開放微創(chuàng)手術(shù)治療急性閉合性跟腱斷裂的臨床療效。方法:回顧性分析2011年9月至2015年12月間我科收治的31例急性閉合性跟腱斷裂患者,根據(jù)手術(shù)方法不同分為經(jīng)皮組(經(jīng)皮Yurt-bone縫合技術(shù)治療,14例)和開放微創(chuàng)組(開放微創(chuàng)手術(shù)治療,17例)。比較兩組患者住院時間、術(shù)中出血量、手術(shù)時間、切口延期愈合率、腓腸神經(jīng)損傷率、小腿最大周徑減少值、單足提踵試驗陽性率、再次斷裂率及末次隨訪時的ATRS功能評分,附加分析彩色超聲多普勒、CT三維重建等影像學檢查結(jié)果。結(jié)果:所有患者術(shù)后獲得平均17.6個月(9~27個月)的隨訪。經(jīng)皮組的住院時間、術(shù)中出血量及手術(shù)時間分別為[(4.2±0.8)d、(8.5±3.6)mL、(41.4±5.3)min],均少于開放微創(chuàng)組的[(5.8±1.3)d、(43.5±7.6)mL、(75.5±7.8)min]差異有統(tǒng)計學意義(P0.05)。經(jīng)皮組和開放微創(chuàng)組患者小腿最大周徑減少值分別為(1.9±0.2)cm和(2.0±0.2)cm,切口延期愈合率分別為0和11.8%,單足提踵試驗陽性率分別為7.1%和5.9%,腓腸神經(jīng)損傷率分別為7.1%和0,ATRS評分分別為(91.2±3.7)分和(90.4±3.3)分,以上指標兩組間比較無統(tǒng)計學意義(P0.05)。兩組所有患者未發(fā)生跟腱再斷裂。結(jié)論:經(jīng)皮Yurt-bone重建方法與微創(chuàng)手術(shù)相比具有住院時間短、手術(shù)時間短、術(shù)中出血量少等優(yōu)勢,未增加相關(guān)并發(fā)癥,可早期功能鍛煉,適合臨床推廣。
[Abstract]:Objective: to compare the clinical efficacy of percutaneous Yurt-bone suture and open minimally invasive surgery in the treatment of acute closed Achilles tendon rupture. Methods: from September 2011 to December 2015, 31 patients with acute closed rupture of Achilles tendon were retrospectively analyzed. According to the different surgical methods, the patients were divided into percutaneous group (14 cases treated by percutaneous Yurt-bone suture) and open minimally invasive group (17 cases treated with open minimally invasive surgery). The duration of hospitalization, intraoperative bleeding, operative time, delayed healing rate of incision, injury rate of sural nerve, maximum circumference of calf, positive rate of one-foot heel test, rerupture rate and ATRS function score at the last follow-up were compared between the two groups. The results of three-dimensional CT reconstruction with color Doppler ultrasound were also analyzed. Results: all patients were followed up for an average of 17.6 months (9 ~ 27 months). The hospitalization time, intraoperative bleeding volume and operative time in the percutaneous group were (4.2 鹵0.8d) and 8.5 鹵3.6m / L (41.4 鹵5.3)min), respectively, which were significantly lower than those in the open minimally invasive group (43.5 鹵7.6mL, 75.5 鹵7.8)min). In the percutaneous group and open minimally invasive group, the maximum circumference reduction of the leg was 1.9 鹵0.2)cm and 2.0 鹵0.2 cm, respectively, the delayed healing rate of incision was 0 and 11.8, the positive rate of one-foot heel test was 7.1% and 5.9%, and the injury rate of sural nerve was 7.1% and 0% respectively. The scores were 91.2 鹵3.7 and 90.4 鹵3.3, respectively. There was no significant difference between the above two groups (P 0.05). No rupture of Achilles tendon occurred in all patients in both groups. Conclusion: compared with minimally invasive surgery, percutaneous Yurt-bone reconstruction has advantages of shorter hospitalization time, shorter operation time, less intraoperative bleeding, no increase of related complications, and early functional exercise, which is suitable for clinical application.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.2

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