方中明　黄鹏　胡剑峰

[摘要] 目的 对比关节镜半月板成形术与半月板切除术治疗膝关节半月板损伤对患者膝关节功能及临床疗效影响。方法 选取2014年3月～2016年1月本院收治的膝关节半月板损伤患者84例，将其按照随机双盲法分为治疗组（44例）及对照组（40例），治疗组患者给予关节镜半月板成形术治疗，对照组给予关节镜半月板切除术治疗，对比两组患者治疗效果和膝关节功能情况。 结果 两组患者经治疗后，治疗组临床总有效率（95.45%）明显优于对照组总有效率（75.00%）；治疗前，两组膝关节功能评分比较差异无统计学意义（P>0.05）；治疗后，两组膝关节功能评分均明显提高，而治疗组膝关节功能评分明显高于对照组（P<0.05）；治疗组选用的关节镜半月板成形术手术时间和出血量显著低于对照组选用的关节镜半月板切除术（P<0.05），治疗组并发症总发生率（4.55%）显著低于对照组（25.00%）（P<0.05）。 结论 关节镜半月板成形术比关节镜半月板切除术治疗膝关节半月板损伤效果更为显著，手术时间较短，术中出血量较少，能更有效的改善患者膝关节功能，且并发症较少，值得临床推广应用。

[关键词] 半月板切除术；半月板成形術；关节镜；半月板损伤

[中图分类号] R684 [文献标识码] B [文章编号] 1673-9701（2018）20-0109-03

Study on two arthroscopic operation techniques in knee meniscus injury

FANG Zhongming HUANG Peng HU Jianfeng HUANG Shujun

Department of Orthopedics， Dingnan Zhongshan Hospital of Jiangxi Province， Dingnan 341900， China

[Abstract] Objective To investigate the influence of meniscus plasty and meniscectomy on the knee function and clinical effectiveness in patients with knee meniscus injury. Methods 84 patients with knee meniscus injury in our hospital from March 2014 to January 2016 were divided into treatment group（44 patients） and control group（40 patients） using random double blind method. Patients in treatment group were treated with arthroscopic meniscus plasty while patients in control group with arthroscopic meniscectomy. Effectiveness and knee function were compared between two groups. Results After treatment in each group， total clinical effective rate of treatment group（95.45%） was significantly higher than that in control group（75.00%）. Before treatment， the scores of knee function in two groups were not statistically different（P>0.05）. After treatment， the scores in two groups increased significantly and the score in treatment group increased more than that in control group（P<0.05）. The operation duration and bleeding volume of arthroscopic meniscus plasty in treatment group were significantly less than those of arthroscopic meniscectomy in control group（P<0.05）. The total incidence of complications in treatment group（4.55%） was significantly lower than that in control group（25.00%）（P<0.05）. Conclusion The effectiveness of arthroscopic meniscus plasty was more significant than arthroscopic meniscectomy. The operation duration is shorter and the intraoperative bleeding volume is less in arthroscopic meniscus plasty. Arthroscopic meniscus plasty could improve the knee function of patients effectively with fewer complications. It would be worth clinical promotion and application.

[Key words] Meniscectomy； Meniscus plasty； Arthroscopy； Meniscus injury

镶嵌在胫骨髁间和胫骨平台的半月形纤维软骨盘为半月板，其主要传递负荷、润滑关节，为膝关节的稳定性和正常活动起着重要的保障作用，同时也能防止股骨移位，避免关节囊和滑囊组织进入关节面[1]。膝关节常见病损之一为半月板损伤，半月板损伤可导致患者膝关节稳定性下降，严重影响其正常的活动。半月板切除术是传统较常用的手术方法，因其见效快、疗效准确等，能够有效缓解半月板损伤后带来的绞锁、疼痛等临床症状。但长期的研究调查显示，半月板切除后极易引发骨性关节炎等疾病[2]。近年来，随着人们对半月板生理功能的深入研究，以保留半月板周围为主的半月板成形术逐渐广泛的应用到临床医学中。因……