全内缝合与内外缝合修补在内侧半月板后角损伤中的应用比较

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摘要目的比较全内缝合修补与内外缝合修补治疗内侧半月板后角损伤的效果差异。方法回顾性分析广州市红十字会医院骨科2014年6月—2018年2月行手术治疗的62 例内侧半月板后角撕裂患者临床资料，依据缝合修补方案分为全内缝合组（35 例）和内外缝合组（27 例）。全内缝合组采取全内缝合修补治疗，内外缝合组采取内外缝合修补治疗，比较两组的临床愈合率、磁共振成像（MRI）愈合率、术中操作时间、手术前后疼痛情况、手术前后膝关节功能、并发症发生情况。结果全内缝合组的术中操作时间短于内外缝合组，临床愈合率、MRI 愈合率高于内外缝合组，差异有统计学意义（P＜0.05）。治疗前，两组患者视觉模拟评分法（VAS）评分、国际膝关节文献委员会膝关节评估表（IKDC）评分比较，差异无统计学意义（P＞0.05）；治疗后，两组VAS 评分低于本组治疗前，IKDC 评分高于本组治疗前，差异有统计学意义（P＜0.05）；全内缝合组的VAS 评分低于内外缝合组，差异有统计学意义（P＜0.05）；IKDC 评分与内外缝合组比较，差异无统计学意义（P＞0.05）。两组均无血管神经损伤、术后感染、关节僵硬病例出现。结论在内侧半月板后角损伤的治疗中全内缝合修补与内外缝合修补相比，愈合更好、术中操作时间更短、术后疼痛更为轻微，可作为优选修补方案加以推广使用。

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关键词 ：内侧半月板, 后角撕裂, 全内缝合修补, 内外缝合修补, 应用比较

Abstract：Objective To compare the effect of total internal suture repair and internal and external suture repair in the treatment of medial meniscus posterior horn injury.Methods The clinical data of 62 patients with medial meniscus posterior angle tear who underwent surgical treatment from June 2014 to February 2018 were retrospectively analyzed.According to the suture repair plan, they were divided into the total internal suture group (35 cases) and the internal and external suture group (27 cases).The internal suture group was treated with internal suture repair, and the internal and external suture group was treated with internal and external suture repair.The clinical healing rate, magnetic resonance imaging (MRI) healing rate, intraoperative operation time, pain before and after surgery, knee function before and after surgery, and complications were compared between the two groups.Results The intraoperative operation time of the total internal suture group was shorter than that of the internal and external suture group, the clinical healing rate and MRI healing rate were higher than those of the internal and external suture group, the differences were statistically significant (P＜0.05).Before the treatment, the visual analogue scale (VAS) score and the international knee documentation committee knee evaluation form (IKDC) score were compared between the two groups of patients, there were no significant differences (P＞0.05).The VAS score after treatment in two groups was lower than that before treatment, and the IKDC score after treatment was higher than that before treatment, the differences were statistically significant (P＜0.05).The VAS score of the total internal suture group was lower than that of the internal and external suture group,the difference was statistically significant (P＜0.05).Compared with the internal and external suture group, the IKDC score was not statistically significant (P＞0.05).There were no cases of vascular nerve injury, postoperative infection, or joint stiffness in the two groups.Conclusion Compared with internal and external suture in the treatment of posterior horn injury of the medial meniscus, total internal suture repair has better healing, shorter operation time and less postoperative pain.Therefore, it could be used as the preferred repair method and promoted.

Key words： Medial meniscus Posterior angle tear Total internal suture repair Internal and external suture repair Application comparison

收稿日期: 2021-03-10

基金资助:广东省广州市产学研协同创新重大专项项目民生科技专题项目（201704020145）；
广东省广州市中医药和中西医结合科研立项资助项目（20202A011011）

作者简介: 王文（1969-），男，广东韶关人，博士，副主任医师，科室负责人，研究方向：关节运动的损伤和修复

引用本文:

王文；王敏；秦胜男；梁绍华；陈亮. 全内缝合与内外缝合修补在内侧半月板后角损伤中的应用比较[J]. 中国当代医药, 2021, 28(20): 17-20.
WANG Wen WANG Min▲ QIN Sheng-nan LIANG Shao-hua CHEN Liang. Application comparison of total internal suture and internal and external suture in repair of posterior angle of medial meniscus. 中国当代医药, 2021, 28(20): 17-20.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I20/17

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