关节镜下治疗盘状半月板损伤临床疗效的影响因素分析(1)
[摘要] 目的 探讨关节镜下治疗盘状半月板损伤临床疗效的影响因素。 方法 选择2018年1～12月在我院手术治疗的盘状半月板损伤患者80例为研究对象，所有患者均行关节镜下部分半月板切除术治疗。比较治疗前后Lysholm评分，治疗后6个月Ikeuchi半月板术后功能评分系统对膝关节功能进行评价。单因素及多因素分析影响患者预后的相关因素。 结果 (1)术前患者Lysholm评分(50.8±5.2)分，术后6个月评分(89.2±4.1)分，治疗前后比较差异有统计学意义(P<0.05)。(2)年龄>40岁、BMI≥24 kg/m2、病程≥1年、混合型撕裂的患者预后优良的比例显著较低，差异有统计学意义(P<0.05)。(3)年龄>40岁、BMI≥24 kg/m2、病程≥1年、混合型撕裂是影响预后因素的独立危险因素(P<0.05)。 结论 关节镜下治疗盘状半月板损伤疗效确切，但仍有部分患者效果欠佳，临床工作中，对于存在高危因素的患者，应制定相关措施，尽量降低相关因素的不良影响。
[关键词] 关节镜;盘状半月板;影响因素;Lysholm评分;Ikeuchi半月板术后功能评分系统
[中图分类号] R687.4 [文献标识码] B [文章编号] 1673-9701(2019)35-0078-03
Analysis of influencing factors for the clinical efficacy of arthroscopic treatment of discoid meniscus injury
CAI Feng YUAN Shuohui
Department of Orthopaedics， Zhuji People's Hospital in Zhejiang Province， Zhuji 311800， China
[Abstract] Objective To investigate the influencing factors for clinical efficacy of arthroscopic treatment of discoid meniscus injury. Methods Eighty patients with discoid meniscus injury who underwent surgery in the hospital from January to December in 2018 were enrolled. All patients underwent arthroscopic partial meniscectomy. The Lysholm score before and after treatment was compared. The Ikeuchi meniscus functional scoring system was used to evaluate knee function 6 months after treatment. The relevant factors affecting patient prognosis were analyzed by univariate and multivariate analysis. Results (1) The Lysholm score of the preoperative patients was (50.8±5.2)， and the score was (89.2±4.1) at 6 months after surgery， and the difference was statistically significant (P<0.05). (2) The proportion of excellent prognosis in patients with age>40 years old， BMI≥24 kg/m2， duration of disease≥1 year and mixed tear was significantly lower， and the difference was statistically significant (P<0.05). (3) Age>40 years， BMI≥24 kg/m2， duration of disease≥1 year， mixed tear were independent risk factors affecting prognostic factors(P<0.05). Conclusion Arthroscopic treatment of discoid meniscus injury is effective， but some patients still have poor results. In clinical work， for patients with high risk factors， relevant measures should be formulated to reduce the adverse effects of related factors.
[Key words] Arthroscopy; Discoid meniscus; Influencing factors; Lysholm score; Ikeuchi meniscus postoperative functional scoring system
半月板有助于增加膝關节骨性匹配，缓冲震荡，吸收能量，并发挥润滑的作用。半月板由纤维软骨组成。正常的半月板内侧呈“C”型，外侧呈圆形，前后角距离近。一部分半月板呈盘状，为一种发育性半月板异常，多发生在外侧。盘状半月板可导致关节间隙增大，腓骨头高位，股骨髁发育不良，棱角消失，胫骨平台软骨软化[1，2]。盘状半月板容易损伤，部分患者可无症状，可不进行处理，对于影响膝关节功能的患者，多采用半月板部分或者全部切除术治疗[3，4]。关节镜下盘状半月板切除术是主要的治疗方法，具有创伤小、恢复快等优点，但仍有部分患者效果欠佳。本文分析影响关节镜下治疗盘状半月板损伤的临床疗效相关因素，以期为临床提供参考。, 百拇医药(蔡峰 袁铄慧)
[关键词] 关节镜;盘状半月板;影响因素;Lysholm评分;Ikeuchi半月板术后功能评分系统
[中图分类号] R687.4 [文献标识码] B [文章编号] 1673-9701(2019)35-0078-03
Analysis of influencing factors for the clinical efficacy of arthroscopic treatment of discoid meniscus injury
CAI Feng YUAN Shuohui
Department of Orthopaedics， Zhuji People's Hospital in Zhejiang Province， Zhuji 311800， China
[Abstract] Objective To investigate the influencing factors for clinical efficacy of arthroscopic treatment of discoid meniscus injury. Methods Eighty patients with discoid meniscus injury who underwent surgery in the hospital from January to December in 2018 were enrolled. All patients underwent arthroscopic partial meniscectomy. The Lysholm score before and after treatment was compared. The Ikeuchi meniscus functional scoring system was used to evaluate knee function 6 months after treatment. The relevant factors affecting patient prognosis were analyzed by univariate and multivariate analysis. Results (1) The Lysholm score of the preoperative patients was (50.8±5.2)， and the score was (89.2±4.1) at 6 months after surgery， and the difference was statistically significant (P<0.05). (2) The proportion of excellent prognosis in patients with age>40 years old， BMI≥24 kg/m2， duration of disease≥1 year and mixed tear was significantly lower， and the difference was statistically significant (P<0.05). (3) Age>40 years， BMI≥24 kg/m2， duration of disease≥1 year， mixed tear were independent risk factors affecting prognostic factors(P<0.05). Conclusion Arthroscopic treatment of discoid meniscus injury is effective， but some patients still have poor results. In clinical work， for patients with high risk factors， relevant measures should be formulated to reduce the adverse effects of related factors.
[Key words] Arthroscopy; Discoid meniscus; Influencing factors; Lysholm score; Ikeuchi meniscus postoperative functional scoring system
半月板有助于增加膝關节骨性匹配，缓冲震荡，吸收能量，并发挥润滑的作用。半月板由纤维软骨组成。正常的半月板内侧呈“C”型，外侧呈圆形，前后角距离近。一部分半月板呈盘状，为一种发育性半月板异常，多发生在外侧。盘状半月板可导致关节间隙增大，腓骨头高位，股骨髁发育不良，棱角消失，胫骨平台软骨软化[1，2]。盘状半月板容易损伤，部分患者可无症状，可不进行处理，对于影响膝关节功能的患者，多采用半月板部分或者全部切除术治疗[3，4]。关节镜下盘状半月板切除术是主要的治疗方法，具有创伤小、恢复快等优点，但仍有部分患者效果欠佳。本文分析影响关节镜下治疗盘状半月板损伤的临床疗效相关因素，以期为临床提供参考。, 百拇医药(蔡峰 袁铄慧)