蔡莉丹 李强 杨宗华 李萌黄欢 李建锋

[摘要]目的探討关节镜下半月板成形术治疗膝关节半月板损伤效果及其对Lysholm评分、关节生理功能的影响。方法回顾性分析常熟市第二人民医院2015年5月至2018年5月收治的60例膝关节半月板损伤患者，根据治疗方案将其分为半月板切除术组（ n=30）和关节镜下半月板成形术组（ n=30），比较两组治疗效果、疼痛程度、膝关节活动度、膝关节恢复情况以及术后并发症发生情况。结果关节镜下半月板成形术组治疗总有效率高于半月板切除术组，差异有统计学意义（ P <0.05）;治疗后关节镜下半月板成形术组 VAS 评分低于半月板切除术组，而膝关节活动度高于半月板切除术组，差异有统计学意义（ P <0.05）;关节镜下半月板成形术组稳定性、行走距离、膝关节恢复总评分高于半月板切除术组，伸直障碍、屈膝障碍评分低于半月板切除术组，差异有统计学意义（ P <0.05）;两组疼痛、行走辅助、渗出评分比较，差异无统计学意义（ P >0.05）;术后随访6个月期间两组均未有明显并发症发生。结论关节镜下半月板成形术可有效降低患者疼痛程度，改善关节生理功能，疗效较好。

[关键词]膝关节半月板损伤;关节镜下半月板成形术;半月板切除术;关节生理功能

[中图分类号] R687.4 [文献标识码] A  [文章编号]2095-0616（2021）22-0185-04

Study on the efficacy of arthroscopic meniscus plasty for knee meniscus injury and its effects on Lysholm score and physiological function of joints

CAI  Lidan   LI  Qiang   YANG  Zonghua   LI  Meng   HUANG  Huan   LI  Jianfeng

Department of Orthopedics， Changshu No.2 People's Hospital， Jiangsu， Changshu 215500， China

[Abstract] Objective To investigate the study of the efficacy of arthroscopic meniscus plasty for knee meniscus injury and its effects on Lysholm score and physiological function of joints. Methods A total of 60 patients with knee meniscus injury admitted to Changshu No.2 People's Hospital from May 2015 to May 2018 were retrospectively analyzed. According to the treatment plan， they were divided into the meniscectomy group （n=30） and the arthroscopic meniscus plasty group （n=30）. The efficacy， pain degree， knee mobility， knee recovery and the occurrence of postoperative complications were compared between the two groups. Results The total effective rate of treatment in the arthroscopic meniscus plasty group was higher than that in the meniscectomy group， with statistically significant difference （P <0.05）. The Visual Analogue Scale （VAS） scores in the arthroscopic meniscus plasty group were lower than those in the meniscectomy group， while the knee mobility was higher than that in the meniscectomy group， with statistically significant differences （P <0.05）. The stability， walking distance， and the total score of knee recovery in the arthroscopic meniscus plasty group were higher than those in the meniscectomy group， while the extension and flexion impairment scores were lower than those in the meniscectomy group， with statistically significant differences （P <0.05）. There were no statistically significant differences between the two groups in pain， walking aid， and exudation scores （P >0.05）. There were no obvious complications in both groups during the 6-month postoperative follow- up. Conclusion Arthroscopic meniscus plasty is effective in reducing the pain degree of patients and improving the physiological function of joints.

[Key words] Knee meniscus injury; Arthroscopic meniscus plasty; Meniscectomy; Physiological function of joints

膝关节半月板损伤是指膝关节在不同诱因下，半月板的完整性和连续性遭到破坏，其临床症状主要为膝关节肿胀、疼痛、僵硬等，严重者会引发关节炎，对患者生活质量及生命健康产生重要影响[1]。膝关节半月板损伤多发生于中老年人，近年来发病率呈明显上升趋势。目前临床对于膝关节半月板损伤的主要治疗方法是半月板切除术，但半月板解剖位置较为复杂，导致手术操作难度较大[2]。关节镜手术属于微创手术，可直接观察关节腔内结构，减轻手术对滑膜的损伤，从而降低术后滑膜炎性反应，显著改善治疗质量[3]。……