两种缝合方法修复闭合性跟腱断裂临床探究.docVIP

两种缝合方法修复闭合性跟腱断裂临床探究 　 作者：高兴华，侯之启,林宇进，黄保华，郑民庆，陈铭，刘永轶 【摘要】 目的 探讨两种方法缝合闭合性跟腱断裂的术后疗效，为临床推广运用提供相应资料。方法 回顾对照研究2005年1月～2006年10月在我院骨科治疗的闭合性跟腱断裂25例，根据手术缝合方法不同分为Krackow方法组与改良Kessler方法组，用抗菌薇荞可吸收线(VICRYLR PLUS)缝合跟腱断裂部，术后小腿石膏固定共6周，同时行功能锻炼，随访术后并发症及疗效。结果 所有患者均获得随访，术后1年总体优良率均在92.31%，两组术后1年内并发症的发生率无明显差别(Pgt;0.05),术后6个月内美国足踝外科功能评分(AFOAS)Krackow组较改良Kessler组高，两组有明显差别(Plt;0.05),术后早期(术后1年内)患者满意率前一种方法较好(Plt;0.05)。结论 临床上运用Krackow方法及改良Kessler两种缝合方法治疗跟腱断裂，术后早期都有良好临床疗效。运用Krackow缝合方法修复跟腱断裂，患者术后早期满意率高。 【关键词】 跟腱断裂;缝合;修复 　　Abstract: Objective To investigate the postoperative results of two methods for suturing closed rupture of the Achilles tendon,so as to provide theoretical basis for clinical application.Methods Twenty five cases of Achilles tendon rupture were reviewed from Jan.2005 to Oct.2006 in our hospital,divided into Krackow method group and modified Kessler method group.All ruptures were repaired with absorbable antimicrobic suturing material (VICRLR.PLUS),immobilized on legs by plaster cast for 6 weeks.Meanwhile,functional training was performed.Postoperative complications and curative effect were followed up.Results All cases were followed up for at least one year,with excellent rate of 92.31% one year postoperation.There was no statistical difference in complication rates within 1 year(Pgt;0.05).AFOAS score in Krackow method group was higher than that in Kessler method group within 6 months postoperation,without statistical difference(Plt;0.05).Patient’s satisfaction rate in Krackow method group was higher than that in Kessler method group in early stage (1 year postoperation),with significant statistical difference(Plt;0.05).Conclusion Both suturing treatments for closed rupture of the Achilles tendon have good clinical results.Patient’s satisfaction rate is higher in the Krackow method group in early stage. 　　Key words:Achilles tendon rupture;suturing;repair 　　由于人们户外工作及体育锻炼机会的增加，闭合性跟腱断裂十分常见，发生率明显上升，流行病学报告高达18/10000[1]，严重影响人们的工作与生活。闭合性跟腱断裂，目前临床上主要有保守治疗、经皮手术及开放手术治疗。三种治疗方法各有优劣势，就疗