自体与异体肌腱重建前十字韧带的对比研究.docVIP

自体与异体肌腱重建前十字韧带的对比研究 　　【摘要】 目的：探讨自体与异体肌腱重建前十字韧带（ACL）临床疗效与不良反应的差异。方法：选取本院膝关节ACL损伤患者98例，采用随机数字表法将其分为观察组与对照组。观察组50例，采用自体肌腱（取自体半腱及股薄肌腱）行关节镜下ACL重建术；对照组48例，采用异体肌腱（同种异体胫前肌腱）行关节镜下ACL重建术，比较两组的近远期疗效与不良反应率的差异。结果：观察组的术后发热时间明显短于对照组，两组比较差异有统计学意义（P0.05）。结论：自体与异体肌腱重建ACL的临床疗效相当，但同种异体材料更容易出现免疫排斥风险，且价格较为昂贵，对于单纯性膝关节ACL损伤患者优先采用自体肌腱重建ACL。 　　【关键词】 自体肌腱； 异体肌腱； 前十字韧带； 重建 　　【Abstract】 Objective：To investigate the clinical efficacy and adverse reactions of autologous and allogeneic tendon reconstruction for anterior cruciate ligament （ACL）.Method： 98 patients with ACL injury were selected and divided into the observation group and the control group randomly.50 cases in the observation group were performed arthroscopic ACL reconstruction from autologous semi tendon and femoral thin tendon.48 cases in the control group were performed ACL reconstruction with allogeneic tendon （allogeneic anterior tibial tendon），the short-term and long-term clinical efficacy and adverse reaction rate of the two groups were compared.Result：The postoperative fever time of observation group was significantly shorter than control group，the difference was statistically significant（P0.05）.Conclusion： The clinical efficacy of autologous and allogeneic tendon reconstruction of ACL are quite similar， but allogeneic tendon reconstruction is more prone to the risk of immune rejection and the price is more expensive，it is priority using autologous tendon reconstruction for simple knee joint ACL injury. 　　【Key words】 Autologous tendon； Allograft tendon； Anterior cruciate ligament； Reconstruction 　　First-author’s address：Huizhou Municipal Central Hospital，Huizhou 516001，China 　　doi：10.3969/j.issn.1674-4985.2015.32.008 　　膝关节前十字韧带（Anterior cruciate ligament，ACL）损伤常见于交通意外伤与运动损伤。膝关节ACL损伤后导致膝关节稳定性降低，严重影响膝关节的运动功能与日常生活质量[1]。同时，膝关节ACL损伤后导致膝关节软骨与膝半月板损伤，导致膝关节退变。目前，关节镜下ACL重建术是治疗膝关节ACL损伤的主要手段，但对于自体肌腱与异体肌腱两种重建移植材料在关节镜下ACL重建术中的应用价值差异尚存在明显的争议[2-3]。本研究通过比较自体肌腱与异体肌腱两种重建移植材料重建膝关节ACL的临床疗效与不良反应，为膝关节ACL重建移植材料的选择提供依据，现报道如下。 　　1 资料与方法