陈淼娣 沈剑增 刘磊

[摘要] 目的 研究直視下手术和关节镜辅助手术对膝关节损伤患者的治疗效果对比。 方法 选取2020年4月至2021年4月我院收治的膝关节损伤患者106例，按照随机数字表法将患者分为直视组、关节镜组，每组各53例。直视组采用传统开放手术进行治疗，关节镜组采用关节镜下手术治疗，对两组患者临床指标、治疗前后膝关节功能（Lysholm）评分、日常生活能力（ADL）评分、应激指标及手术效果，不良反应发生情况进行比较。采用膝关节症状量表对患者膝关节功能进行评价;采用日常生活能力评定量表对患者生活能力进行评价;采用酶联免疫吸附法对应激指标进行检测。 结果 与直视组比较，关节镜组手术时间、活动时间、住院时间、功能恢复时间显著降低（P<0.05）;术后与直视组比较，关节镜组Lysholm评分、ADL评分显著升高（P<0.05）;术后与直视组比较，关节镜组应激指标显著降低（P<0.05）;关节镜组比直视组手术总有效率显著升高，术后并发症发生率降低（P<0.05）。 结论 采用关节镜辅助手术能够有效改善手术效果，对患者膝关节功能恢复及减轻创伤应激反应有一定的帮助，安全性较好，有利于患者恢复。

[关键词] 直视下手术;关节镜辅助手术;膝关节损伤;膝关节功能

[中图分类号] R687          [文献标识码] B          [文章编号] 1673-9701（2021）32-0098-04

[Abstract] Objective To study the comparison of therapeutic effects of direct vision surgery and arthroscopically assisted surgery on patients with knee joint injury. Methods A total of 106 patients with knee joint injury admitted to our hospital from April 2020 to April 2021 were selected and divided into direct vision group （n=53） and arthroscopic group （n=53） according to random number table method. The direct vision group was treated with traditional open surgery， while the arthroscopic group was treated with arthroscopic surgery. The clinical indicators， knee function （Lysholm） score， activities of daily living （ADL） score， stress indicators， and surgical effects before and after treatment， and the occurrence of adverse reactions were statistically analyzed and compared between the two groups. Knee function was evaluated by the knee symptom scale. Patients' living ability was evaluated using the Activities of Daily Living Rating Scale. Stress index was detected by enzyme-linked immunosorbent assay. Results Compared with the direct vision group， the operation time， activity time， hospital stay， and functional recovery time in the arthroscopic group were significantly reduced （P<0.05）. Compared with the direct vision group， the Lysholm score and ADL score in the arthroscopic group were significantly increased after the operation （P<0.05）. The stress index in the arthroscopic group was significantly reduced after the operation（P<0.05）. The overall response rate in the arthroscopic group was significantly increased compared with the direct vision group， and the incidence rate of postoperative complications was reduced（P<0.05）. Conclusion Arthroscopically assisted surgery can effectively improve the surgical effect， help the recovery of knee joint function and reduce the traumatic stress response， with good safety， which is conducive to the recovery of patients.

[Key words] Direct vision surgery; Arthroscopically assisted surgery; Knee joint Injury; Knee joint function

膝關节损伤是临床上常见的一种疾病，会直接造成患者关节功能下降，疼痛程度严重。若未及时治疗，会给患者的行动及生活带来严重的影响[1]。临床上通常采用手术进行治疗，目前只有两种方式，一种是传统手术，一种是膝关节镜手术，其能够改善患者受损关节及临床症状，保护患者的膝关节功能[2-4]。……