邓伟 丁雪勇 文涛

[摘要] 目的 探討关节镜半月板成形术联合功能锻炼治疗膝关节半月板损伤的治疗效果及其对关节功能和活动度的影响。 方法 选取2013年4月～2015年3月重庆市第五人民医院骨科诊治的68例膝关节半月板损伤患者为研究对象，依据治疗方法的不同分为关节镜半月板成形术组（单独组）和关节镜半月板成形术联合功能锻炼组（联合组），每组各34例，分别比较两组患者的临床疗效、关节功能和活动度。 结果 单独组的优良率为47.0%，显著低于联合组的85.29%，差异有统计学意义（P < 0.05）；术后，尽管单独组患者的Lysholm评分、IKDC和活动度均有所改善，但联合组的恢复程度显著优于单独组，差异有统计学意义（P < 0.05）；此外，联合组的HSS总分也明显高于单独组，差异有统计学意义（P < 0.05）；联合组患者在稳定性、行走距离、伸直障碍和屈曲障碍方面明显优于单独组，差异有统计学意义（P < 0.05），但两组患者在疼痛、行走辅助和渗出方面比较，差异无统计学意义（P > 0.05）。 结论 关节镜半月板成形术联合功能锻炼可以显著提高膝关节半月板损伤的临床疗效，改善关节功能，提高关节活动度。

[关键词] 关节镜半月板成形术；功能锻炼；关节功能；活动度

[中图分类号] R684.76 [文献标识码] A [文章编号] 1673-7210（2016）03（c）-0108-04

[Abstract] Objective To investigate the therapeutic effect of arthroscopic meniscus formation combined with functional exercise in the treatment of knee joint meniscus injury and its effect on joint function and activity. Methods From April 2013 to March 2015， in Department of Orthopedics， the Fifth People's Hospital of Chongqing City， 68 patients with knee joint meniscus injury were selected and divided into the arthroscopic meniscus angioplasty group （single group） and arthroscopic meniscus angioplasty combined with functional exercise group （combined group） according to the different treatments， 34 cases in each group. The clinical efficiency， joint function and activity were compared between two groups. Results The efficiency rate of the single group was 47.0%， which was significantly lower than that of the combined group at 85.29%， the difference was statistically significant （P < 0.05）. After surgery， although the Lysholm score， IKDC and activity of the individual group were improved， the recovery degree of the combination group were significantly better than those of the single group， the differences were statistically significant （P < 0.05）； In addition， the HSS scores of combination group were significantly higher than single group， the difference was statistically significant （P < 0.05）； The stability， the walking distance， flexion and extension barrier of the combined group were all obviously superior to the single group， the differences were statistically significant （P < 0.05）， but the pain， walking， exudation had no significant difference between two groups （P > 0.05）. Conclusion Arthroscopic meniscus formation combined with functional exercise can significantly enhance the clinical efficacy of knee meniscus injury， improve joint function， and increase the activity of joint.

[Key words] Arthroscopic meniscus formation； Functional exercise； Joint function； Activity

半月板损伤是膝关节运动性创伤中最常见的骨科疾病，因其解剖位置复杂、个体变异大，手术治疗难度相对较高[1-2]。关节镜半月板成形术具有创伤小、视野清晰、术后康复快等优点，正逐步成为治疗半月板损伤的主要术式之一[3-4]。据此，本研究以重庆市第五人民医院（以下简称“我院”）诊治的膝关节半月板损伤的患者为研究对象，探讨关节镜半月板成形术联合功能锻炼治疗膝关节半月板损伤的治疗效果及其对关节功能和活动度的影响，现总结报道如下：

1 资料与方法

1.1 一般资料

选取2013年4月～2015年3月我院骨科诊治的68例膝关节半月板损伤患者为研究对象，所有患者均经MRI确诊，临床症状显示为膝关节交锁，患侧局部压痛，McMurray征阳性，关节镜观察有撕裂的半月板；……