关节镜下半月板部分切除术结合理疗对不稳定半月板撕裂的疗效
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摘要
目的该文主要针对关节镜下半月板部分切除术(APM)结合理疗对不稳定半月板撕裂的疗效进行分析。方法在该院2015年6月—2016年5月收治的所有确诊患有不稳定半月板撕裂的患者中选取124例患者,无规律平均分为两组,每组62例,分别为APM(实验组)与物理理疗(对照组),观察两组患者的VAS与Lysholm评分。两组患者进行3次/周物理治疗,主要针对肌肉的锻炼与神经功能的恢复。在进行理疗治疗后1周开始进行关节镜下半月板部分切除术。并对不同治疗阶段及术后对患者进行随访,对疼痛度进行视觉模拟评分法(VAS)并对膝关节韧带损伤条件进行特异性评分(Lysholm)。VAS以0分表示无痛感,10分为痛感满分,Lysholm评分方法以与膝关节功能相关的临床指标改善情况为评分标准。结果 38例患者在视觉模拟评分中由(5.35±1.02)分,结合理疗降至(4.25±0.93)分(P<0.05);在特异性评分中由(56.96±7.65)分,结合理疗提升至(65.28±9.56)分(P=0.001)。结论理疗法虽能使患者的症状有一定程度的缓解,但对关节的活动无明显改善,而半月板部分切除术能对患者病症进行更为深层次的治疗,并改善膝关节的活动状态。
Objective To analyze the effect of partial meniscus excision(APM) combined with physiotherapy on unstable meniscus tear. Methods 124 cases of patients with unstable meniscal tear diagnosed in our hospital from June 2015 to May 2016 were randomly divided into two groups, with 62 cases in each group, respectively including APM(experimental group) and physical therapy(control group), and the VAS and Lysholm of the two groups were observed. Two groups of patients were treated with 3 physical treatments a week, mainly for muscle exercise and recovery of nerve function. Arthroscopic partial meniscectomy was performed 1 week after the treatment of physiotherapy. The patients were followed up for different stages of treatment and postoperative. Visual analogue scale(VAS) for pain was performed, and the condition of knee ligament injury was evaluated by specific score(Lysholm). VAS showed a painless sense of 0 points, 10 points as a pain full score, and the Lysholm score was used to improve the clinical indicators related to the knee joint function. Results The visual analogue scale of 38 cases decreased from(5.35±1.02)points to(4.25±0.93)points, after combining with physical therapy(P<0.05); the specific score increased from(56.96±7.65)points to(65.28±9.56)points(P=0.001), after combined with physical therapy. Conclusion Although physiotherapy can relieve the symptoms of patients, it has no obvious improvement on the activities of joints, while partial meniscectomy can further treat patients' symptoms and improve the activity of knee joints.
Objective To analyze the effect of partial meniscus excision(APM) combined with physiotherapy on unstable meniscus tear. Methods 124 cases of patients with unstable meniscal tear diagnosed in our hospital from June 2015 to May 2016 were randomly divided into two groups, with 62 cases in each group, respectively including APM(experimental group) and physical therapy(control group), and the VAS and Lysholm of the two groups were observed. Two groups of patients were treated with 3 physical treatments a week, mainly for muscle exercise and recovery of nerve function. Arthroscopic partial meniscectomy was performed 1 week after the treatment of physiotherapy. The patients were followed up for different stages of treatment and postoperative. Visual analogue scale(VAS) for pain was performed, and the condition of knee ligament injury was evaluated by specific score(Lysholm). VAS showed a painless sense of 0 points, 10 points as a pain full score, and the Lysholm score was used to improve the clinical indicators related to the knee joint function. Results The visual analogue scale of 38 cases decreased from(5.35±1.02)points to(4.25±0.93)points, after combining with physical therapy(P<0.05); the specific score increased from(56.96±7.65)points to(65.28±9.56)points(P=0.001), after combined with physical therapy. Conclusion Although physiotherapy can relieve the symptoms of patients, it has no obvious improvement on the activities of joints, while partial meniscectomy can further treat patients' symptoms and improve the activity of knee joints.
引文
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[8]金亚平,徐刚,金建华,等.关节镜治疗膝关节盘状半月板损伤的疗效及术后疼痛的危险因素分析[J].中华全科医学,2015,13(11):1796-1798.
[9]谈绎文,郑昱新,顾新丰,等.关节镜治疗成人外侧盘状半月板的短期疗效及软骨损伤对疗效的影响[J].中国骨与关节损伤杂志,2017(10):1079-1081.
[10]梁学振,田原,王少山,等.关节镜下一期治疗前交叉韧带损伤合并半月板桶柄样撕裂的疗效观察[J].中国修复重建外科杂志,2017(5):547-552.
[2]金永鑫.关节镜下半月板切除或缝合术治疗外侧半月板撕裂合并关节软骨损伤[J].中医正骨,2017,29(5):45-47.
[3]鄢志辉,杨柳,郭林,等.关节镜下双极射频消融治疗外侧半月板撕裂合并外侧间室软骨损伤的疗效分析[J].中国修复重建外科杂志,2014(1):13-16.
[4]鄢志辉.关节镜下治疗外侧半月板撕裂合并不同程度软骨损伤的疗效分析[D].重庆:第三军医大学,2014.
[5]王庆,黄华扬,张涛,等.关节镜下半月板成形缝合术治疗盘状半月板损伤的近期疗效研究[J].中华关节外科杂志:电子版,2015(3):26-29.
[6]杨砥,刘炯,赵滨,等.关节镜下半月板部分切除结合修补术治疗波及血管区的外侧盘状半月板破裂[J].贵州医药,2013,37(7):604-605.
[7]王徐龙,要鹏.关节镜下半月板部分切除术治疗半月板损伤近期疗效影响因素分析[J].解放军预防医学杂志,2017,35(7):765-767.
[8]金亚平,徐刚,金建华,等.关节镜治疗膝关节盘状半月板损伤的疗效及术后疼痛的危险因素分析[J].中华全科医学,2015,13(11):1796-1798.
[9]谈绎文,郑昱新,顾新丰,等.关节镜治疗成人外侧盘状半月板的短期疗效及软骨损伤对疗效的影响[J].中国骨与关节损伤杂志,2017(10):1079-1081.
[10]梁学振,田原,王少山,等.关节镜下一期治疗前交叉韧带损伤合并半月板桶柄样撕裂的疗效观察[J].中国修复重建外科杂志,2017(5):547-552.