关节镜下治疗腘窝囊肿临床疗效研究-外科学(骨科)专业论文.docxVIP

摘要 摘要 万方数据 万方数据 摘 要 目的： 探讨关节镜下治疗腘窝囊肿的安全性及其近期临床疗效。 方法： 研究 2012 年 1 月—2013 年 12 月，南昌大学第一附属医院收治的 46 例腘窝 囊肿患者的临床资料，其中原发性腘窝囊肿 6 例，继发性腘窝囊肿 40 例，所有 患者均行 MRI 确诊。原发性腘窝囊肿采用关节外关节镜监视下切除囊肿囊壁， 并加压包扎 2 周。继发性腘窝囊肿在关节镜下处理关节内原发病，同时在关节 镜直视下，通过关节内切除囊肿囊壁。所有患者术前行膝关节 Lysholm 功能评 分及 Rauschning 和 Lindgren 腘窝囊肿分级。术后观察患者有无关节内血肿，切 口及关节内感染，神经、血管损伤及膝关节僵硬等术后并发症，并于末次随访 时再次行膝关节 Lysholm 功能评分及 Rauschning 和 Lindgren 腘窝囊肿分级，评 估治疗效果。 结果： 所有患者均顺利完成手术，术后均未出现切口及关节内感染，关节内血肿， 神经、血管损伤及关节僵硬术后并发症。术后均获得有效随访，术后随访时间 2~12 个月，平均（5.15±2.67）个月，术前及末次随访时膝关节 Lysholm 功能评 分分别为（46.09±14.69）分及（84.54±9.28）分，术后较术前明显提升，差异有 统计学意义（Z=-5.906，P＜0.01）。术前、术后 Rauschning 和 Lindgren 腘窝囊肿 分级结果为术前 0 级 0 例，I 级 2 例，II 级 15 例，III 级 29 例；术后 0 级 20 例， I 级 18 例，II 级 8 例，III 级 0 例。术后 I 级的患者较术前明显提高，I 级以上比 例为 82.61%（38/46），比较差异有统计学意义（χ2=50.22，P＜0.01）。 结论： 关节镜下治疗腘窝囊肿是一种安全、有效的方法。 关键词：腘窝囊肿；关节镜；膝关节；治疗 II Abst Abstract ABSTRACT Objective: To evaluate the safety and recent clinical efficacy of the arthroscopic excision popliteal cyst. Methods: From January 2012 to December 2013, 46 cases of clinical data with popliteal cyst were treated by arthroscopic excision in The First Affiliated Hospital of Nanchang University. There were 6 cases of primary popliteal cyst and 40 cases of secondary popliteal cyst. All of the cases accepted MRI to make a definite diagnosis. We treated the primary popliteal cyst by inserting the arthroscopy in the cyst and excising the capsule directly in extra-articular, afterwards pressurized the incision for 2 weeks at postoperative. And we treated the secondary popliteal cyst by using intra-articular arthroscopic excising the capsule and treatment of the intra-articular protopathy. All cases were assessed by Lysholm Knee Function Score、 Rauschning and Lindgren popliteal cyst classification at preoperative. Observed complications of the intra-articular hematoma, incision and intra-articular infection, nerval and vascular injury and the knee stiffness at postoperative. The postoperative clinical efficacy was evaluated by using Lyshol