欧锐金 谭文乐 黄东博 谭建基

[摘要]目的比较两种方法修复屈指肌腱Ⅱ区肌腱损伤的临床效果。方法选取2018年1月至2020年12月罗定市人民医院外二科收治的70例屈指肌腱Ⅱ区肌腱损伤患者，随机分为观察组与对照组，每组各35例。对照组患者接受 U 型法干预，观察组患者接受 Kessler 法干预。比较两种缝合方法干预后患者的手指运动功能损伤评分和 Carroll 上肢功能评分，并使用主动活动度法评价综合治疗效果。结果治疗前，两组患者的 Carroll 上肢功能评分和手指运动功能损伤评分比较，差异无统计学意义（P >0.05）。接受不同术式治疗1个月后，兩组患者的 Carroll 上肢功能评分高于治疗前，差异有统计学意义（ P <0.05）。观察组患者的 Carroll 上肢功能评分高于对照组，差异有统计学意义（ P <0.05）。接受不同术式治疗1个月后，两组患者的手指运动功能损伤评分均低于治疗前，差异有统计学意义（ P <0.05）。观察组患者的手指运动功能损伤评分低于对照组，差异有统计学意义（ P <0.05）。观察组患者治疗后的优良率高于对照组，差异有统计学意义（ P <0.05）。结论 Kessler 法修复屈指肌腱Ⅱ区肌腱损伤的短期临床效果优于传统 U 型缝合法，有利于患者上肢和手指运动功能的康复。远期临床效果仍有待于延长随访时间进一步观察。

[关键词]屈指肌腱;肌腱损伤;肌腱缝合;运动功能

[中图分类号] R686.1 [文献标识码] A  [文章编号]2095-0616（2021）22-0162-04

Clinical comparison of two methods for repairing zone Ⅱ flexor tendon injuries

OU  Ruijin   TAN  Wenle   HUANG  Dongbo   TAN  Jianji

Department of Surgery Ⅱ ， Luoding People's Hospital， Guangdong， Luoding 527200， China

[Abstract] Objective To compare the clinical effects of two methods for repairing tendon injuries in zone Ⅱ of the flexor tendon. Methods A total of 70 patients with tendon injury in zone Ⅱ of the flexor tendon admitted to the Department of Surgery Ⅱ of Luoding People's Hospital from January 2018 to December 2020 were selected and randomly divided into the observation group and the control group， with 35 cases in each group. Patients in the control group were intervened with the U-shaped suturing method， while patients in the observation group were intervened with the Kessler's suturing method. The finger motor function impairment scores and Carroll upper extremity function scores of patients after the intervention of the two suture methods were compared， and the comprehensive efficacy was evaluated using the active mobility method. Results Before treatment， there were no statistically significant differences between the two groups in Carroll upper extremity function scores and finger motor function impairment scores （P >0.05）. After 1 month of treatment with different suturing methods， the Carroll upper extremity function scores of patients in both groups were higher than those before treatment， with statistically significant differences （P <0.05）. The Carroll upper extremity function scores of patients in the observation group were higher than those of patients in the control group， with statistically significant difference （P <0.05）. After 1 month of treatment with different suturing methods， the finger motor function impairment scores of patients in both groups were lower than those before treatment， with statistically significant differences （P <0.05）. The finger motor function impairment scores of patients in the observation group were lower than those of patients in the control group， with statistically significant difference （P <0.05）. The excellent rate of treatment in the observation group was higher than that in the control group， with statistically significant difference （P <0.05）. Conclusion The short-term clinical efficacy of the Kessler's suturing method for repairing tendon injuries in zone Ⅱ of the flexor tendon is better than that of the traditional U-shaped suturing method， and the Kessler's suturing method is more effective in promoting the rehabilitation of patients' upper extremity and finger motor functions. However， the long- term clinical efficacy still need to be further observed during the extended follow-up period.

[Key words] Flexor tendon; Tendon injury; Tendon suture; Motor function

屈指肌腱损伤是临床上常见的手外伤疾病，根据相关流行病学研究显示，手部损伤中合并肌腱损伤或单纯肌腱损伤的发生率可高达30%[1]。由于手功能的特殊性，一旦治疗不当或疗效欠佳，轻则导致患肢美观受到影响，重则影响患肢手部功能，甚至发生残疾[2]。尤其对于Ⅱ区肌腱而言，由于解剖结构相对复杂，损伤机会多，术后粘连风险大，治疗效果往往差强人意。Ⅱ区肌腱断裂后如何进行修复有利于促进肌腱愈合、降低粘连风险和改善手部功能一直是相关领域的研究热点和难点[3]。本研究选取2018年1月至2020年12月收治的70例屈指肌腱Ⅱ区肌腱损伤患者，比较两种方法修复屈指肌腱Ⅱ区肌腱损伤的临床效果。现报……