本文選題：Fast-Fix + 半月板損傷��； 參考：《成都中醫(yī)藥大學(xué)》2015年碩士論文

【摘要】：目的：本課題旨在通過對進行了關(guān)節(jié)鏡下Fast-Fix半月板縫合患者臨床資料的收集,分析病程與半月板縫合術(shù)后臨床療效之間的相關(guān)性,為臨床治療提供依據(jù)。方法：選取2011-2013年期間在四川省中醫(yī)醫(yī)院骨科住院并符合納入標(biāo)準(zhǔn)的76例患者(81例膝),收集患者一般資料：病程、性別、年齡、損傷部位、損傷形態(tài)。根據(jù)病程長短以Keene時間劃分標(biāo)準(zhǔn)[1],將患者按病程分為三組：A、B、C組。A組：急性期32例；B組：亞急性期25例；C組：慢性期19例。各組術(shù)前均行膝關(guān)節(jié)MRI檢查評估半月板損傷情況,并行關(guān)節(jié)鏡檢十半月板縫合術(shù)。術(shù)前及術(shù)后3、6、12月隨訪時均進行疼痛視覺模擬評分法(visual analogue scale,簡稱VAS)評分、膝關(guān)節(jié)功能Lysholm評分,術(shù)后隨訪時進行半月板臨床愈合情況Barrett標(biāo)準(zhǔn)[2]的評估。根據(jù)結(jié)果分析病程與半月板縫合術(shù)后臨床療效之間的相關(guān)性。結(jié)果：76例病人都進行了完整隨訪。結(jié)果顯示各組術(shù)前及術(shù)后疼痛VAS評分差異均有統(tǒng)計學(xué)意義(P0.05),術(shù)前與術(shù)后膝關(guān)節(jié)功能Lysholm評分差異均有統(tǒng)計學(xué)意義(P0.05),根據(jù)Barrett標(biāo)準(zhǔn),A組臨床愈合率為96.88%,B組臨床愈合率為92.00%,C組臨床愈合率為89.47%,關(guān)節(jié)鏡下Fast-Fix全內(nèi)縫合法治療半月板損傷總體臨床愈合率為93.42%。A、B、C三組之間術(shù)后3、6、12月疼痛VAS評分差異均無統(tǒng)計學(xué)意義(P0.05)；A、B、C三組之間術(shù)后3月膝關(guān)節(jié)功能Lysholm評分差異有統(tǒng)計學(xué)意義(P0.05),但術(shù)后6、12月膝關(guān)節(jié)功能Lysholm評分差異均無統(tǒng)計學(xué)意義(P0.05)；A、B、C三組術(shù)后3、6、12月半月板臨床愈合率差異均無統(tǒng)計學(xué)意義(P0.05)。結(jié)論：關(guān)節(jié)鏡下Fast-Fix全內(nèi)縫合法是治療半月板損傷的一種有效方法,總體臨床愈合率為93.42%。早期縫合有利于膝關(guān)節(jié)功能更快恢復(fù),但病程長短對半月板縫合術(shù)后遠期臨床療效沒有明顯影響。建議Ⅲ級半月板損傷不論病程長短均應(yīng)盡早進行半月板縫合,Fast-Fix全內(nèi)縫合法操作簡單、療效可靠,可以廣泛運用于半月板損傷治療過程中。
[Abstract]:Objective: to collect the clinical data of Fast-Fix meniscus suture under arthroscopy and to analyze the correlation between the course of disease and the clinical effect after meniscus suture so as to provide the basis for clinical treatment. Methods: from 2011 to 2013, we selected 76 patients who were hospitalized in orthopedics department of Sichuan traditional Chinese Medicine Hospital and 81 patients with knee joint. The general data of the patients were collected: course of disease, sex, age, injury location, injury form. According to the criteria of Keene duration, the patients were divided into three groups according to the course of the disease: group A: group B: 32 cases in acute stage, group B: group C in subacute stage: group C: 19 cases in chronic stage. The meniscus injury was evaluated by MRI and 10 meniscus suture under arthroscopy. Visual analogue scale (vas), knee function Lysholm and meniscus healing were evaluated by visual analogue score (VAS) before operation and 6 months after operation and 12 months after operation by Barrett standard [2]. According to the results, the correlation between the course of disease and the clinical effect after meniscus suture was analyzed. Results all 76 patients were followed up. The results showed that the difference of VAS score before and after operation was statistically significant (P 0.05). The Lysholm score of knee joint function before and after operation was significantly different (P 0.05). According to the Barrett standard, the clinical healing rate of group A was 96.8888% and that of group B was lower than that of group B. The clinical healing rate of group C was 89.47. The overall clinical healing rate of meniscus injury treated by Fast-Fix total suture under arthroscopy was 93.42.AmeBHN C after operation. There was no significant difference in VAS score of pain in 12 months between the three groups. There was no significant difference in VAS score of knee joint work 3 months after operation between the three groups. There was significant difference in Lysholm score between the three groups (P 0.05), but there was no significant difference in the Lysholm score of knee joint function at 6 and 12 months after operation. There was no significant difference in the clinical healing rate of meniscus in the three groups after operation (P 0.05) and the meniscus healing rate in 12 months (P 0.05). Conclusion: total Fast-Fix suture under arthroscopy is an effective method for meniscus injury. The overall clinical healing rate is 93.42. Early suture was beneficial to the recovery of knee function, but the duration of the disease had no significant effect on the long term clinical effect after meniscus suture. It is suggested that the Fast-Fix total suture of meniscus suture should be carried out as early as possible in grade 鈪，

本文編號：1974051