杨叶锋++梁树威++劳贵昌++林树体

【摘要】目的 观察关节镜下治疗肘关节骨性关节炎的效果。方法选择收治的31例肘关节骨性关节炎患者，均采用关节镜技术进行治疗，观察手术前后活动范围情况，记录手术前、术后3个月、术后6个月时患者最大屈曲度和最大伸直度；采用Mayo评分系统对比术后3个月、术后6个月的疗效。结果所有患者均顺利完成手术，切口均Ⅰ期愈合。所有患者均获得随访，随访时间为6～12个月，平均8.5个月。术后3个月、术后6个月时两组疗效比较差异无统计学意义（P>0.05）。术前、术后3个月、术后6个月时的最大屈曲度、最大伸直度、Mayo评分比较差异均有统计学意义（P<0.01），术后3个月、术后6个月时的最大屈曲度、最大伸直度、Mayo评分较术前显著改善（P<0.01），术后3个月、术后6个月时的最大屈曲度、最大伸直度、Mayo评分比较差异无统计学意义（P>0.05）。术后均未出现明显的并发症，无术后血管神经损伤发生。结论关节镜手术是治疗肘关节骨性关节炎的有效方法，能明显改善术后肘关节功能，安全性高，值得临床推广。

【关键词】肘关节；骨性关节炎；关节镜；关节清理；肘关节功能

中图分类号：R684.3 文献标识码：ADOI：10.3969/j.issn.10031383.2015.06.013

Effectiveness analysis of arthroscopic treatment for elbow joint osteoarthritis

YANG Yefeng，LIANG Shuwei，LAO Guichang，LIN Shuti

（The First Peoples Hospital of Qinzhou，Qinzhou 535000，Guangxi，China）

【Abstract】ObjectiveTo observe the effectiveness of arthroscopic treatment for elbow joint osteoarthritis.Methods31 patients with elbow joint osteoarthritis were treated by arthroscopic technique.Range of motion（ROM） before and after treatment were compared.Maximum flexibility and straightness before surgery，3 months and 6 months after surgery were recorded.In addition，Mayo scoring system was applied to compare effectiveness 3 months and 6 months after surgery.Results The operation was completed successfully in all patients，and incisions healed in the first intention.All cases were followed up for 6 to 12 months （mean 8.5 months）.Difference of effectiveness 3 months and 6 months after surgery was not statistically significant（P>0.05）.Difference of maximum flexibility and straightness before surgery，3 months and 6 months after surgery as well as Mayo score was statistically significant（P<0.01）.Maximum flexibility and straightness 3 months and 6 months after surgery as well as Mayo score significantly improved，and difference was not statistically significant（P>0.05）.No obvious complications and neurovascular damage were found after operation.ConclusionArthroscopic operation is an efficacy method in the treatment of elbow joint osteoarthritis，which can obviously improve the elbow joint functions with high security.Thus，it is worthy of clinical application.

【Key words】elbow joint osteoarthritis；arthroscope；joint debridement；elbow joint function

骨性关节炎以膝关节、髋关节、手指等部位多见，肘关节较为少见。肘关节骨性关节炎病理上表现为炎性或瘢痕化滑膜形成并卡压于关节间隙内以及异常骨结构形成，导致患者肘关节活动受限、疼痛等，主要发生于从事重体力劳动及反复使用上肢的中年男性，患者多有肘关节过度使用史[1]。传统的开放性手术暴露范围大、周围软组织剥离广泛，破坏大、出血量多、并发症多，肘关节功能恢复受到影响。肘关节镜下微创手术能明显减少开放性手术造成的创伤，近年来也逐渐尝试运用于肘关节骨性关节炎的治疗，并且效果明显[2]。我科2012年1月～2014年10月对31例肘关节骨性关节炎患者实施了关节镜下关节清理术，疗效满意，现报告如下。endprint