| 局部麻醉下关节镜手术摘除腘窝囊肿并膝关节腔清理的临床疗效观察 |
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投稿时间：2017-04-10
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| 作者 | Author | 单位 | Address | E-Mail |
| 李冀 |
LI Ji |
解放军总医院骨科六病区, 北京 100853 |
The Sixth Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China |
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| 李众利 |
LI Zhong-li |
解放军总医院骨科六病区, 北京 100853 |
The Sixth Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China |
lizhongli@263.net |
| 张浩 |
ZHANG Hao |
解放军总医院骨科六病区, 北京 100853 |
The Sixth Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China |
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| 王克涛 |
WANG Ke-tao |
解放军总医院骨科六病区, 北京 100853 |
The Sixth Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China |
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| 杨以萌 |
YANG Yi-meng |
解放军总医院骨科六病区, 北京 100853 |
The Sixth Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China |
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| 苏祥正 |
SU Xiang-zheng |
解放军总医院骨科六病区, 北京 100853 |
The Sixth Department of Orthopaedics, General Hospital of Chinese PLA, Beijing 100853, China |
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| 期刊信息：《中国骨伤》2017年，第30卷，第10期，第920-925页 |
| DOI：10.3969/j.issn.1003-0034.2017.10.009 |
| 基金项目: |
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中文摘要:
目的：观察局部麻醉关节镜下腘窝囊肿摘除并膝关节腔清理的临床疗效。
方法：2009年2月至2014年8月共52例腘窝囊肿的患者在局部麻醉关节镜下行腘窝囊肿摘除并膝关节腔清理手术，其中男34例，女18例；年龄14～62岁，平均43.6岁；右膝29例，左膝23例。术前根据MRI表现进行诊断并判断是否合并其他膝关节疾病，52例均在术前诊断为腘窝囊肿，其中23例合并单纯半月板损伤或软骨损伤，18例合并骨性关节炎，7例合并交叉韧带损伤，2例痛风性关节炎，1例类风湿性关节炎，1例色素沉着绒毛性结节性关节炎。术前患者临床表现：膝关节肿胀21例，膝关节疼痛16例，关节绞锁8例，腿无力4例，膝关节弹响4例。囊肿大小：4.0 cm×3.3 cm～6.2 cm×5.3 cm.根据Rauschning和Lindgren 标准分级如下：Ⅰ级1例，Ⅱ级9例，Ⅲ级42例。术后康复计划要根据患者具体的损伤情况及术中处理情况来制定。术后定期复查，使用Rauschning和Lindgren腘窝囊肿分级标准评定术后疗效。
结果：所有患者术后切口Ⅰ期愈合，无相关并发症。52例均获随访，时间39.6个月（25～64个月）.末次随访时根据Rauschning和Lindgren分级标准：0级43例，Ⅰ级8例，Ⅱ级1例，较术前改善（Z=-7.38，P=0.000）.
结论：局部麻醉关节镜下腘窝囊肿摘除并膝关节腔清理术的效果确切，创伤小，恢复快，短期随访效果良好。由于可以同时处理膝关节原发疾病，因此复发率也很低。术后应根据术中处理情况制定相应的康复计划并积极训练以便早日康复。 |
| 【关键词】膝关节 腘囊肿 关节镜 |
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| Clinical research of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia |
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ABSTRACT
Objective:To evaluate the clinical effects of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia.
Methods:From February 2009 to August 2014,52 patients with popliteal cysts were treated in our hospital,including 34 males and 18 females with an average age of 43.6 years old ranging from 14 to 62 years old; 29 cases were on the right knee and 23 on the left knee. Preoperative diagnosis was performed according to MRI findings and to determine whether other knee disorders were associated with the disease,52 patients were diagnosed as popliteal cyst before operation;23 cases of simple meniscus injury or cartilage injury,18 cases of osteoarthritis,7 cases of cruciate ligament injury,2 cases of gouty arthritis,1 case of rheumatoid arthritis,1 case of pigmented villonodular arthritis. The preoperative clinical manifestations involved knee swelling in 21 cases,knee joint pain in 16 cases,joint lock in 8 cases,leg weakness in 4 cases,and knee joint snapping in 4 cases. Cyst size was 4.0 cm×3.3 cm to 6.2 cm×5.3 cm. According to the Rauschning and Lindgren standards,1 case was gradeⅠ,9 cases were gradeⅡ,42 cases were class Ⅲ. The rehabilitation plan should be made according to the patient's specific injuries and intraoperative management. During the postoperative follow-up,the postoperative curative effect was evaluated by the standard grading of Rauschning and Lindgren of popliteal cyst.
Results:All the incisions healed by first intention,and no complications occurred. All the cases were followed up from 25 to 64 months (averaged 39.6 months). For the Rauschning and Lindgren grading,43 cases were grade 0,8 cases were gradeⅠ,1 case were gradeⅡ.
Conclusion:Local anesthesia under arthroscopy and popliteal cyst removal knee joint cavity debridement is effective,less trauma,quick recovery,short term effect is good. The recurrence rate is also low because of the primary disease of the knee joint is also treated. After the operation,the rehabilitation plan should be made according to the intraoperative treatment and actively trained so as to recover at an early date. |
| KEY WORDS Knee joint Popliteal cyst Arthroscopes |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李冀,李众利,张浩,王克涛,杨以萌,苏祥正.局部麻醉下关节镜手术摘除腘窝囊肿并膝关节腔清理的临床疗效观察[J].中国骨伤,2017,30(10):920~925 |
| 英文格式: | LI Ji,LI Zhong-li,ZHANG Hao,WANG Ke-tao,YANG Yi-meng,SU Xiang-zheng.Clinical research of popliteal cyst excision combined with debridement of the knee under arthroscopy with local anesthesia[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(10):920~925 |
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