超声引导定位在膝关节镜手术中的应用效果

doi:10.3760/cma.j.issn.1007-1245.2023.04.009

国际医药卫生导报 ›› 2023, Vol. 29 ›› Issue (4): 480-483.DOI: 10.3760/cma.j.issn.1007-1245.2023.04.009

超声引导定位在膝关节镜手术中的应用效果

刘景云¹ 张莉¹ 任强^1,2

¹滨州医学院附属医院骨关节外科，滨州　256600；²中国石油大学（华东），青岛　266580

收稿日期:2022-10-25 出版日期:2023-03-15 发布日期:2023-03-05
通讯作者: 任强，Email：w.person@163.com
基金资助:
山东省医药卫生科技发展计划项目（2017WS040）；2020年产学合作协同育人项目（202002204024）；滨州医学院徐荣祥再生医学发展计划项目（BY2019XRX04）

Application of ultrasound guided localization in knee arthroscopic surgery

Liu Jingyun¹, Zhang Li¹, Ren Qiang^1,2

¹Department of Bone and Joint Surgery, Binzhou Medical University Hospital, Binzhou 256600, China; ²China Petroleum University (East China), Qingdao 266580, China

Received:2022-10-25 Online:2023-03-15 Published:2023-03-05
Contact: Ren Qiang, Email: w.person@163.com
Supported by:
Project of Development Plan of Medical and Health Science and Technology in Shandong Province (2017WS040); Collaborative Education Project of Production and University Cooperation in 2020 (202002204024); Project of Xu Rongxiang Regenerative Medicine Development Plan of Binzhou Medical University (BY2019XRX04)

摘要/Abstract

摘要：

目的　研究超声引导定位在膝关节镜手术中的应用效果。方法　将2020年1月至2021年2月期间于滨州医学院附属医院行膝关节镜手术治疗的200例膝关节疾病患者，通过随机数字表法分为传统组和超声组，各100例。传统组中，男55例，女45例，年龄（46.82±6.25）岁，采用传统解剖定位法建立膝关节镜前外侧通道；超声组中，男53例，女47例，年龄（46.48±5.64）岁，采用超声引导下定位法建立膝关节镜前外侧通道。采用t、χ²检验比较两组患者手术时间、关节内组织损伤并发症发生率、术后7 d和14 d的视觉模拟量表（VAS）评分。结果　超声组手术时间为（68.96±21.09）min，低于传统组［（76.17±23.45）min］，两组比较，差异有统计学意义（t=-2.286，P<0.05）。超声组术中操作导致关节内组织损伤并发症发生率为3%（3/100），低于传统组的10%（10/100），两组比较，差异有统计学意义（χ²=4.031，P<0.05）。超声组术后7、14 d的VAS评分分别为（3.78±1.00）分、（1.68±0.71）分，均低于传统组［（4.67±0.94）分、（2.54±0.69）分］，两组比较，差异均有统计学意义（t=-6.485、-6.686，均P<0.001）。结论　对于行膝关节镜手术的患者，术中采用超声引导定位法建立前外侧通道可减少关节内组织损伤并发症发生率及手术时间，减轻患者术后早期疼痛，值得推广。

关键词:

关节镜, 超声引导, 外科手术, 并发症

Abstract:

Objective　To study the effect of ultrasound guided localization in knee arthroscopic surgery. Methods　Two hundred patients with knee joint diseases who underwent knee arthroscopic surgery in Binzhou Medical University Hospital from January 2020 to February 2021 were divided into a traditional group and an ultrasonic group by the random number table method, with 100 patients in each group. The traditional group had 55 males and 45 females who were (46.82 ± 6.25) years old; the anterolateral channels of knee arthroscopy were established by the traditional anatomical positioning method in the traditional group. The ultrasonic group had 53 males and 47 females who were (46.48 ± 5.64) years old; the anterolateral channels of knee arthroscopy were established by the ultrasound guided positioning method in the ultrasonic group. The operation times, incidences of intra-articular tissue injury, and pain scores of Visual Analogue Scale (VAS) 7 and 14 days after the operation were compared between the two groups by t and χ² tests. Results　The operation time in the ultrasonic group was shorter than that in the traditional group [(68.96±21.09) min vs.(76.17±23.45) min], with a statistical difference (t=-2.286, P<0.05). The incidence of intra-articular tissue injury caused by operation in the ultrasonic group was lower than that in traditional group [3% (3/100) vs. 10% (10/100); (χ²=4.031, P<0.05). The VAS scores 7 and 14 days after the operation in the ultrasound group were lower than those in the traditional group [(3.78±1.00) vs. (4.67±0.94) and (1.68±0.71) vs. (2.54±0.69)], with statistical differences between the two groups (t=-6.485 and -6.686, both P<0.05). Conclusion　For patients undergoing knee arthroscopic surgery, the establishment of anterolateral channels with ultrasound guided localization during the operation can reduce the operation time, the incidence of intra-articular tissue injury, and the patients' early postoperative pain, so it is worthy of promotion.

Key words:

Arthroscopy, Ultrasound-guided, Surgery, Complications

刘景云张莉任强.

超声引导定位在膝关节镜手术中的应用效果 [J]. 国际医药卫生导报, 2023, 29(4): 480-483.

Liu Jingyun, Zhang Li, Ren Qiang.

Application of ultrasound guided localization in knee arthroscopic surgery [J]. International Medicine and Health Guidance News, 2023, 29(4): 480-483.

参考文献

[1] Reigstad O, Grimsgaard C. Complications in knee arthroscopy[J]. Knee Surg Sports Traumatol Arthrosc, 2006,14(5):473-477. DOI: 10.1007/s00167-005-0694-x.
[2] Pierzchała A, Kusz D, Widuchowski J. Complication of arthroscopy of the knee[J]. Wiad Lek, 2003,56(9-10):460-467. DOI:10.1302/0301-620X.84B7.13637.
[3] 赵铁军,单鹏程,孙钢,等.膝骨关节炎关节镜清理术并发症病因分析及对策[J].中国骨与关节损伤杂志,2016,31(8):814-816.DOI:10.7531/j.issn.1672-9935.2016.08.009.
[4] 王志为,林源,曲铁兵.膝关节镜手术入路的技巧及相关解剖[J].中华解剖与临床杂志,2015,20(6):589-592.DOI:10.3760/cma.j.issn.2095-7041.2015.06.028.
[5] Nemade SV, Shinde KJ. Clinical Efficacy of tinnitus retraining therapy based on tinnitus questionnaire score and visual analogue scale score in patients with subjective tinnitus[J]. Turk Arch Otorhinolaryngol, 2019,57(1):34-38. DOI: 10.5152/tao.2019.3091.
[6] Dong J, Xu H, Jin G, et al. The adaptive change of patellofemoral joint after arthroscopic discoid lateral meniscus plasty: an observational study[J]. Medicine (Baltimore), 2018,97(6):e9827. DOI: 10.1097/MD.0000000000009827.
[7] Rai MF, McNulty AL. Meniscus beyond mechanics: using biology to advance our understanding of meniscus injury and treatment[J]. Connect Tissue Res, 2017,58(3-4):221-224. DOI: 10.1080/03008207.2017.1312921.
[8] 吴俊涛,张鹏远,李军章,等.膝关节镜关节清理术联合透明质酸钠治疗髌股关节炎膝前痛临床研究[J].国际医药卫生导报,2017,23(1):56-58.DOI:10.3760/cma.j.issn.1007- 1245. 2017.01.018.
[9] 张维国.关节镜辅助下微创手术治疗胫骨平台骨折患者的效果[J].国际医药卫生导报,2021,27(17):2761-2763.DOI:10.3760/cma.j.issn.1007-1245.2021.17.032.
[10] 张凯搏,毛贝尼,张钟,等.中国膝关节镜手术相关并发症发生率的系统评价[J].中国循证医学杂志,2019,19(12):1400-1408.DOI:10.7507/1672-2531.201907138.
[11] 王立德,张羽飞,齐志明,等. 膝关节镜下手术并发症及意外[C]//中华医学会第八届骨科学术会议暨第一届国际COA学术大会论文摘要集,2006.
[12] Baumgarten M, Bloebaum RD, Ross SD,et al. Normal human synovial fluid: osmolality and exercise-induced changes[J]. J Bone Joint Surg Am, 1985,67(9):1336-1339. DOI: 10.3109/17453678508993047.
[13] Farhan-Alanie MM, Hall AC. Temperature changes and chondrocyte death during drilling in a bovine cartilage model and chondroprotection by modified irrigation solutions[J]. Int Orthop, 2014,38(11):2407-2412. DOI: 10.1007/s00264-014-2350-x.
[14] Rai V, Dilisio MF, Dietz NE, et al. Recent strategies in cartilage repair: a systemic review of the scaffold development and tissue engineering[J]. J Biomed Mater Res A, 2017,105(8):2343-2354. DOI: 10.1002/jbm.a.36087.
[15] Newman AP. Articular cartilage repair[J]. Am J Sports Med, 1998,26(2):309-324. DOI: 10.1177/03635465980260022701.
[16] 辛龙,张春,徐卫星,等.膝关节软骨损伤的外科治疗进展[J].中国骨伤,2018,31(3):281-285.DOI:10.3969/j.issn. 1003-0034.2018.03.019.
[17] Hunter DJ, Zhang Y, Niu J, et al. Increase in bone marrow lesions associated with cartilage loss: a longitudinal magnetic resonance imaging study of knee osteoarthritis[J]. Arthritis Rheum, 2006,54(5):1529-1535. DOI: 10.1002/art.21789.
[18] 陈有荣,林霖,颜昕,等.局灶性关节软骨缺损外科治疗的研究现状[J].中国矫形外科杂志,2021,29(12):1100-1104.DOI:10.3977/j.issn.1005-8478.2021.12.10.
[19] Kemmochi M, Sasaki S, Takahashi M, et al. The use of platelet-rich fibrin with platelet-rich plasma support meniscal repair surgery[J]. J Orthop, 2018,15(2):711-720. DOI: 10.1016/j.jor.2018.05.006.
[20] Pache S, Aman ZS, Kennedy M, et al. Meniscal root tears: current concepts review[J]. Arch Bone Jt Surg, 2018, 6(4):250-259. DOI: 10.22038/abjs.2018.26273.1694.
[21] Laprade CM, James EW, Engebretsen L, et al. Anterior medial meniscal root avulsions due to malposition of the tibial tunnel during anterior cruciate ligament reconstruction: two case reports[J]. Knee Surg Sports Traumatol Arthrosc, 2014,22(5):1119-1123. DOI: 10.1007/s00167-014-2868-x.
[22] Steineman BD, LaPrade RF, Santangelo KS, et al. Early osteoarthritis after untreated anterior meniscal root tears: an in vivo animal study[J]. Orthop J Sports Med, 2017,5(4):2325967117702452. DOI: 10.1177/2325967117702452.
[23] 郑晓芬.骨关节炎发病机制和治疗的最新进展[J].中国组织工程研究,2017,21(20):3255-3262.DOI:10.3969/j.issn.2095-4344.2017.20.022.
[24] 蒋青,林共周,田得祥.膝关节镜手术并发症及其防治[J].中国运动医学杂志,2000,19(1):15-16.DOI:10.3969/j.issn.1000-6710.2000.01.006.
[25] 张经纬,蒋垚,赵金忠,等.722例膝关节镜清理术并发症分析[J].中国骨与关节损伤杂志,2005,20(9):592-594.DOI:10.3969/j.issn.1672-9935.2005.09.007.
[26] 梁学振,王少山,魏姗姗.膝关节镜术后并发症的分析[J].实用中西医结合临床,2014,14(7):75-76.DOI:10.13638/j.issn.1671-4040.2014.07.051.

超声引导定位在膝关节镜手术中的应用效果

Application of ultrasound guided localization in knee arthroscopic surgery

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