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囊壁硬化联合关节镜治疗大面积复发性腘窝囊肿疗效观察

CURATIVE EFFECT OF CYSTIC WALL SCLEROSIS COMBINED WITH ARTHROSCOPY IN THE TREATMENT OF LARGE AREA RECURRENT POPLITEAL CYST
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摘要 目的探讨囊壁硬化联合关节镜治疗大面积复发性腘窝囊肿疗效。方法选取2013年1月—2018年9月我院收治的77例腘窝囊肿患者为研究对象,根据入院时治疗方法将患者分为联合组(24例)、关节镜组(23例)及穿刺组(30例)。联合组采用囊壁硬化联合关节镜下囊肿内引流治疗;关节镜组仅采用关节镜下囊肿内引流治疗;穿刺组仅采用无水乙醇治疗。观察三组患者治疗疗效、手术情况、术后不同时间视觉模拟疼痛评分(VAS)及Lysholm评分、患者术后复发及并发症发生情况。结果联合组患者总有效率明显高于关节镜组及穿刺组(P<0.05),但穿刺组与关节镜组比较差异无统计学意义(P>0.05)。术后联合组VAS评分明显低于关节镜组及穿刺组,而Lysholm评分明显高于关节镜组及穿刺组(P<0.05)。术后联合组患者并发症总发生率明显低于关节镜组及穿刺组(P<0.05)。术后联合组复发3例,关节镜组复发12例,穿刺组复发5例,三组比较差异有统计学意义(P<0.05)。单因素及多因素分析显示手术时间、切口长度及手术方式均与患者术后复发密切相关。结论囊壁硬化联合关节镜治疗大面积复发性腘窝囊肿疗效好、并发症少、复发率低,可在临床推广应用。 Objective To investigate the effect of cystic wall sclerosis combined with arthroscopy in the treatment of large area recurrent popliteal cyst.Methods From January 2013 to September 2018,seventy-seven patients with popliteal cyst admitted to Affiliated Hospital of North China University of Science and Technology were selected as research subjects.According to the treatment methods at admission,the patients were divided into combined group(24 cases),arthroscopic group(23 cases)and puncture group(30 cases).The combined group was treated with cyst wall sclerosis combined with intracyst drainage under arthroscope,while the arthroscopic group was treated with intracyst drainage under arthroscope only,and the puncture group was treated with absolute ethanol only.The curative effect,operation condition,VAS and Lysholm scores at different time after operation,recurrence and complications of the three groups were observed.Results The total effective rate of the combined group was significantly higher than that of the arthroscopic group and the puncture group(P<0.05),but there was no significant difference between the puncture group and the arthroscopic group(P>0.05).The VAS score of combined group was significantly lower than that of arthroscopic group and puncture group,while Lysholm score was significantly higher than that of arthroscopic group and puncture group(P<0.05).The total incidence of complications in the combined group was significantly lower than that in the arthroscopic group and the puncture group(P<0.05).There were 3 recurrences in the combined group,12 in the arthroscopic group and 5 in the puncture group.There was significant difference among the three groups(P<0.05).Univariate and multivariate analysis showed that operation time,incision length and operation method were closely related to recurrence.Conclusion The combination of cystic wall sclerotherapy combined with arthroscopy for the treatment of large-area recurrent axillary cysts has good curative effect,less complications and low recurrence rate,
作者 刘昊 甘洪全 孙晓新 梁春雨 刘英杰 Liu Hao;Gan Hongquan;Sun Xiaoxin;Liang Chunyu;Liu Yingjie(Department of Orthopedics,Affiliated Hospital of North China University of Science and Technology,Tangshan 063000,China)
出处 《中国煤炭工业医学杂志》 2019年第2期118-123,共6页 Chinese Journal of Coal Industry Medicine
基金 河北省卫生和计划生育委员会青年科技课题(编号:20180790).
关键词 囊壁硬化 关节镜 腘窝囊肿 Cystic wall sclerosis Arthroscopy Popliteal fossa cyst
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