不同手术方式在腘窝囊肿中的疗效及对疼痛程度的控制效果比较

李冰 李松军 黄志明 张弓 卞春喜 赵俊延 叶小聪

【摘要】 目的：分析不同手術方式在腘窝囊肿中的疗效及对疼痛程度的控制效果。方法：选取2018年6月-2021年6月本院收治的80例腘窝囊肿患者，按照不同手术方式将患者分为传统手术组与膝关节镜手术组，各40例。传统手术组给予传统手术治疗，膝关节镜手术组给予膝关节镜手术治疗。比较两组手术时间、切口长度及住院总时长，术前、术后24 h和术后1周疼痛视觉模拟评分法（VAS）变化，术前和术后12周膝关节功能评分变化，分析两组患者手术治疗效果以及术后并发症的发生率。结果：与传统手术组相比，膝关节镜手术组手术时间、切口长度以及住院总时长均较短（P<0.05）;术后24 h、1周，膝关节镜手术组VAS评分均较术前降低（P<0.05），传统手术组VAS评分均较术前升高（P<0.05），且膝关节镜手术组VAS评分均低于传统手术组（P<0.05）。术后12周，两组膝关节活动范围和Lysholm膝关节评分均高于术前（P<0.05），且膝关节镜手术组膝关节活动范围和Lysholm膝关节评分均高于传统手术组（P<0.05）。传统手术组临床总有效率低于膝关节镜手术组（P<0.05）。两组术后并发症发生率比较，差异无统计学意义（P>0.05）。结论：与传统手术相比，膝关节镜手术对腘窝囊肿患者的疗效更好，且对患者疼痛感程度有着较好的控制效果。

【关键词】 膝关节镜手术 传统手术 腘窝囊肿 疼痛程度

Comparison of Therapeutic Effects and Pain Control Effects of Different Surgical Methods in Popliteal Cyst/LI Bing， LI Songjun， HUANG Zhiming， ZHANG Gong， BIAN Chunxi， ZHAO Junyan， YE Xiaocong. //Medical Innovation of China， 2021， 18（35）： 0-014

[Abstract] Objective： To analyze the curative effect of different surgical methods in popliteal cyst and the control effect of pain degree. Method： A total of 80 patients with popliteal cysts treated in our hospital from June 2018 to June 2021 were selected， and the patients were divided into conventional surgery group and knee arthroscopic surgery group according to different surgical procedures， with 40 cases in each group. The conventional surgery group was given traditional surgical treatment， the knee arthroscopic surgery group was given knee arthroscopy treatment. Operative time， incision length as well as total length of hospital stay of the two groups， the changes of visual analogue scale （VAS） of pain before operation， 24 h and 1 week after operation， and the changes of knee function score before operation and 12 weeks after operation were analyzed and compared， the effect of surgical treatment and the incidence of postoperative complications were analyzed. Result： Operative time， incision length as well as total length of hospital stay were shorter in the knee arthroscopic surgery group compared to the conventional surgery group （P<0.05）. VAS scores at 24 h and 1 week after surgery in the knee arthroscopic surgery group were lower than those before surgery （P<0.05）， and VAS scores at 24 h and one week after surgery in the conventional surgery group were higher than those before surgery （P<0.05）， and VAS scores in the knee arthroscopic surgery group at 24 h and 1 week after surgery were lower than those in the conventional surgery group （P<0.05）. At 12 weeks after surgery， the range of motion and Lysholm knee scores of the two groups were higher than those before operation （P<0.05）， and the range of motion and Lysholm knee scores of the knee arthroscopic surgery group were higher than those of the traditional surgery group （P<0.05）. The effective rate of traditional surgery group was lower than that of knee arthroscopic surgery group （P<0.05）. There was no significant difference in the total incidence of postoperative complications between the two groups （P>0.05）. Conclusion： Compared with traditional surgery， knee arthroscopic surgery is more effective in patients with popliteal cyst， and has a better control effect on the degree of pain.

[Key words] Knee arthroscopy Traditional surgery Popliteal cyst Degree of pain

First-authors address： The Fifth Affiliated Hospital of Zunyi Medical University， Zhuhai 519100， China

doi：10.3969/j.issn.1674-4985.2021.35.003

腘窝囊肿是临床常见的膝关节周围囊性病变，属于腱鞘囊肿的一种。腘窝囊肿好发生于腓肠肌内侧头与半膜肌之间，有研究认为，腘窝囊肿与膝关节腔内病变相关，临床上主要分为原发性、继发性两种[1-2]。原发性腘窝囊肿常发生于青少年，容易自行愈合，继发性腘窝囊肿临床上往往需要进行手术治疗。临床上常用的手段为传统手术和膝关节镜手术治疗[3-4]。传统手术虽然具有一定的疗效，但会存在手术切口长、术中出血量多、并发症多的情况[5]。随着内镜技术的发展，近年来膝关节镜手术广泛地应用于半月板损伤、交叉韧带等多种膝关节疾病之中。……