摘要
目的比较关节镜下后内侧双入路活瓣切除联合囊壁切除术与传统开放手术在治疗腘窝囊肿中的临床疗效。方法选择2018年5月至2023年5月于昆山市第二人民医院骨科接受治疗的64例腘窝囊肿患者作为研究对象,根据随机数字表法分为联合组和传统组,每组32例。联合组采用关节镜下后内侧双入路活瓣切除联合囊壁切除术,传统组采用传统开放手术。比较2组患者的手术情况、疼痛程度、炎症水平、膝关节功能、生活质量以及治疗后并发症及复发率。结果联合组术中出血量少于传统组,切口长度、手术时间及住院天数均短于传统组(P<0.05)。术后6个月联合组与传统组Rauschning-Lindgren分级均较术前有所改善(P<0.05),但2组患者Rauschning-Lindgren分级比较差异无统计学意义(P>0.05)。术后6、24、48 h联合组的视觉模拟量表(VAS)评分均低于传统组(P<0.05),膝关节活动范围、Lysholm膝关节评分高于传统组,下肢力线角度小于传统组(P<0.05)。炎症水平方面,联合组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、IL-8及C反应蛋白(CRP)水平均低于传统组(P<0.05)。联合组生活质量综合评定量表(QOL)各维度评分高于传统组(P<0.05),治疗后并发症发生率低于传统组(P<0.05)。结论关节镜下后内侧双入路活瓣切除联合囊壁切除术在减少术中出血、缩短手术时间和住院天数、降低疼痛程度、提高膝关节功能及生活质量方面,相比传统开放手术具有更佳的临床效果,可在腘窝囊肿的治疗中应用。
Objective To compare the clinical efficacy between arthroscopic posteromedial dual-portal valvotomy combined with cyst wall resection and open surgery in the treatment of popliteal cysts.Methods A total of 64 patients with popliteal cysts who were treated in the Kunshan Second People’s Hospital from May 2018 to May 2023 were enrolled and randomly assigned to two groups.The combined group(n=32)underwent arthroscopic posteromedial dual-portal valvotomy combined with cyst wall resection,and the traditional group(n=32)underwent open surgery.Surgery-related parameters,pain,inflammatory levels,knee joint function,quality of life,postoperative complications and recurrence rate were compared between the two groups.Results The combined group had less intraoperative blood loss and shorter incision length,operation time,and hospital stay than the traditional group(P<0.05).The Rauschning-Lindgren grade was improved at 6 months after surgery in both groups(P<0.05),but there was no significant difference in the Rauschning-Lindgren grade at 6 months after surgery between the two groups(P>0.05).VAS scores at 6,24 and 48 h postoperatively,lower limb alignment angles,and the levels of interleukin(IL)-6,tumor necrosis factor-α,IL-8,and C reactive protein in the combined group were lower than those in the traditional group(P<0.05).The range of motion of the knee,Lysholm knee scores,and QOL scores in all dimensions in the combined group were higher than those in the traditional group(P<0.05).The incidence of postoperative complications in the combined group was lower than that in the traditional group(P<0.05).Conclusion Arthroscopic posteromedial dual-portal valvotomy combined with cyst wall resection is superior to open surgery in the treatment of popliteal cysts,with less intraoperative blood loss,shorter operation time and hospital stay,lower pain levels,better knee joint function and higher quality of life.
作者
郭继伟
徐宏扣
胡建华
冯齐德
Guo Jiwei;Xu Hongkou;Hu Jianhua;Feng Qide(Department of Orthopedics,Kunshan Second People’s Hospital,Kunshan 215300,China)
出处
《海军医学杂志》
2025年第3期262-267,共6页
Journal of Navy Medicine
基金
江苏省自然科学基金面上项目(BK20201154)。
关键词
腘窝囊肿
关节镜下手术
后内侧双入路
传统开放手术
临床疗效
Popliteal cyst
Arthroscopic surgery
Posteromedial dual-portal approach
Open surgery
Clinical efficacy
