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开放缝合与小切口非对接缝合器治疗急性闭合性跟腱断裂的临床对比研究

2019-07-11陈泽群任绍东屠永刚马邦兴张史飞袁浩彬

中外医学研究 2019年10期

陈泽群 任绍东 屠永刚 马邦兴 张史飞 袁浩彬

【摘要】 目的:探討急性闭合性跟腱断裂患者采用开放缝合及小切口非对接缝合器的疗效差异。方法:将36例为急性闭合性跟腱断裂患者随机平均分为试验组与对照组,试验组采用小切口非对接缝合器治疗,对照组应用开放缝合治疗。对两组患者手术期间失血量及手术时间、术后踝关节背伸及踝关节功能评分、术后不良并发症情况进行记录与对比分析。结果:两组患者术后踝关节背伸及功能评分比较,差异无统计学意义(P>0.05)。而试验组术中失血量及手术时间均优于对照组低,差异均有统计学意义(P<0.05)。对照组术后并发症发生率为16.7%,试验组术后并发症发生率为0,差异有统计学意义(P<0.05)。结论:采用开放缝合及小切口非对接缝合器对急性闭合性跟腱断裂患者进行治疗,均具有一定的效果。其中,小切口非对接缝合器造成的创伤相对较小,患者切口愈合良好,不良并发症发生率低,具有一定的临床应用价值。

【关键词】 急性闭合性跟腱断裂; 开放缝合; 小切口非对接缝合器

doi:10.14033/j.cnki.cfmr.2019.10.006 文献标识码 A 文章编号 1674-6805(2019)10-00-03

Clinical Comparative Study of Open Suture and Small Incision Non-butting Stapler for the Treatment of Acute Closed Achilles Tendon Rupture/CHEN Zequn,REN Shaodong,TU Yonggang,et al.//Chinese and Foreign Medical Research,2019,17(10):-15

【Abstract】 Objective:To investigate the efficacy and differences in the treatment of patients with acute closed Achilles tendon rupture with open suture and small incision.Method:Thirty-six patients with acute closed Achilles tendon rupture were randomly divided into experimental group and control group.The experimental group was treated with small incision non-butting stapler,and the control group was treated with open suture.The blood loss and operation time during the operation,as well as the postoperative ankle joint extension and ankle function scores and postoperative adverse complications were recorded and compared.Result:There was no significant difference in the data of the ankle joint extension and functional score between the two groups(P>0.05).The blood loss and operation time in the experimental group were better than those in the control group,and the differences were statistically significant(P<0.05).In terms of postoperative complications,the incidence of complications in the control group was 16.7%,while in the experimental group was 0,the difference was statistically significant(P<0.05).Conclusion:Open suture and small incision non-butting stapler for the treatment of patients with acute closed Achilles tendon rupture have certain effects.Among them,the small incision non-coupling stapler caused relatively small trauma,the patients incision healed well,the incidence of adverse complications was low,and it has certain clinical application value.

【Key words】 Acute closed Achilles tendon rupture; Open suture; Small incision non-butting stapler

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

综上所述,应用开放缝合与小切口非对接缝合器对急性闭合性跟腱断裂患者进行治疗均具有一定的效果,但其中小切口非对接缝合器手术时间较短,术中失血量较少,术后并发症发生率低,具有较好的临床推广与应用价值。

参考文献

[1]欧娈海,陆荣斌,赵国平,等.急性闭合性跟腱断裂的微创治疗[J].中国矫形外科杂志,2015,23(14):1341-1343.

[2] Knobe M,Gradl G,Klos K,et al.Is percutaneous suturing superior to open fibrin gluing in acute Achilles tendon rupture?[J].International Orthopaedics,2015,39(3):535-542.

[3]陳柯屹,曹万军,张梦苑,等.非手术与手术修复急性闭合性跟腱断裂的Meta分析[J].中国组织工程研究,2015,19(15):2449-2454.

[4] Holm C,Kjaer M,Eliasson P,et al.Achilles tendon rupture - treatment and complications:A systematic review[J].Scandinavian Journal of Medicine & Science in Sports,2015,25(Pt.1):E1-E10.

[5]王晓宁,朱颖波,黄鑫,等.新型微创缝合技术治疗急性闭合性跟腱断裂[J].中华创伤骨科杂志,2016,18(3):187-191.

[6] Miller L,Spittler J,Khodaee M,et al.Management of Acute Achilles Tendon Rupture[J].American Family Physician,2015,91(11):794-800.

[7] Corradino B,Di L S,Calamia C,et al.Surgical repair of acute Achilles tendon rupture with an end-to-end tendon suture and tendon flap[J].Injury,2015,46(8):1637-1640.

[8]方家刘,詹俊锋,李军,等.急性闭合性跟腱断裂的治疗进展[J].中华骨科杂志,2018,38(1):53-59.

[9]赵飞,巩凡,李晓亮,等.急性闭合性跟腱断裂28例患者的5年随访研究[J].中华显微外科杂志,2017,40(4):324-327.

[10]李兵,杨云峰,陈凯,等.跟腱断端束束缝合治疗急性闭合性跟腱断裂[J].中华创伤杂志,2016,32(10):898-902.

[11]秦余焕,李建扬,杨先腾,等.环钳经皮缝合与开放缝合治疗急性闭合性跟腱断裂的比较研究[J].中华创伤骨科杂志,2017,19(6):500-504.

[12]阿依娜孜·巴达力汗.手术治疗与非手术治疗急性闭合性跟腱断裂伤的随访研究[D].乌鲁木齐:新疆医科大学,2016.

[13]杨明,张晓萌,张殿英,等.两种微创技术治疗跟腱断裂的比较研究[J].中华创伤骨科杂志,2016,18(3):192-196.

[14]余炯杰,颜丹,李甲,等.急性闭合性跟腱断裂手术治疗进展[J].实用骨科杂志,2017,23(9):820-823.