三种术式治疗腘窝囊肿的比较
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于永杰,主治医师,研究方向:关节运动医学,(电话)15966168687,(电子信箱)93679187@qq.com

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R738.1

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山东省自然科学基金面上项目(编号:ZR2021MH071);2021 年度山东省博士后创新项目(编号:202103083);中国博士后科学基金第68 批面上资助二等项目(编号:2020M682220);中国博士后科学基金第 14 批特别资助项目(编号:2021T140423);山东省医药卫生科技发展计划项目(编号:2018WS075)


Comparison of three surgical procedures for popliteal cyst
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    摘要:

    [目的]比较关节镜下囊肿切除(arthroscopic cystectomy, AC)、镜下内引流术(arthroscopic internal drainage, AID)及传统开放切除(traditional open cytectomy, TOC)治疗腘窝囊肿的临床疗效。[方法]回顾性分析 2015 年 3 月—2019 年 3 月本科手术治疗 108 例腘窝囊肿患者的临床资料。依据术前医患沟通结果,38 例采用镜下 AC,35 例采用 AID,35 例采用 TOC。比较三组围手术期、随访及影像等资料。[结果]108 例患者均顺利完成手术,无神经、血管损伤等并发症。AC 与 AID 组切口长度、手术时间、失血量、下地时间、切口愈合等级及住院时间均显著优于 TOC 组(P<0.05);AID 组手术时间显著优于 AC、TOC 组 (P<0.05)。所有患者随访时间均 12 个月以上。随时间推移,三组 VAS 评分显著降低 (P<0.05),而 Lysholm 评分明显增加 (P<0.05)。末次随访时,AC 组与 AID 组 VAS 评分显著低于 TOC 组 (P<0.05);AC 组的 Lysholm 评分显著优于 AID 与 TOC 组 (P<0.05)。至末次随访时,影像学显示,AC 组与 AID 组腘窝囊肿复发率显著低于 TOC 组(P<0.05)。相应时间点三组间膝关节退变 Kellgren-Lawrence 评级的差异无统计学意义(P>0.05)。[结论]与开放切除相比,镜下囊肿切除术与镜内引流术具有复发率低的优势。其中,镜下囊肿切除术膝关节功能恢复疗效更为满意。

    Abstract:

    [Objective] To compare the clinical outcomes of arthroscopic cystectomy (AC) , arthroscopic internal drainage (AID) and tra- ditional open cystectomy (TOC) for popliteal cyst. [Methods] A retrospective analysis was performed on 108 patients who underwent surgi- cal treatment for popliteal cyst in our department from March 2015 to March 2019. According to preoperative doctor-patient communication, 38 patients underwent AC, the other 35 patients underwent AID, while the remaining 35 received TOC. The perioperative, follow-up and im- aging data of the three groups were compared. [Results] All the 108 patients had the corresponding procedure performed successfully with- out neurovascular injury and other complications. The AC and AID groups were significantly superior to the TOC group in terms of incision length, operation time, blood loss, postoperative ambulation, incision healing and hospital stay (P<0.05) . The AID group had significantly shorter operation time than the AC and TOC groups (P<0.05) . As time went in follow-up period lasted for more than 12 months, the VAS score significantly decreased (P<0.05) , while the Lysholm score significantly increased in all the 3 groups (P<0.05) . At last follow-up, the AC and AID groups got significantly lower VAS scores than the TOC group (P<0.05) , while the AC group was marked significantly higher Lysholm score than the AID and TOC groups (P<0.05) . Radiographically, the AC and AID groups had significantly lower recurrence of popli- teal cyst than the TOC group (P<0.05) . However, there were no significant differences in Kellgren-Lawrence grade of knee degeneration among the three groups at any corresponding time points (P>0.05) . [Conclusion] The arthroscopic cystectomy and arthroscopic internal drainage have the advantage of low cyst recurrence over the traditional open cystectomy. Among them, arthroscopic cystectomy does achieve more satisfactory knee function recovery.

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引用本文

于永杰,马亮,王传鑫,等. 三种术式治疗腘窝囊肿的比较[J]. 中国矫形外科杂志, 2023, 31 (5): 402-407. DOI:10.3977/j. issn.1005-8478.2023.05.04.
YU Yong-jie, MA Liang, WANG Chuan-xin, et al. Comparison of three surgical procedures for popliteal cyst[J]. ORTHOPEDIC JOURNAL OF CHINA , 2023, 31 (5): 402-407. DOI:10.3977/j. issn.1005-8478.2023.05.04.

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  • 收稿日期:2022-04-08
  • 最后修改日期:2022-09-27
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  • 在线发布日期: 2023-03-20
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