摘要
目的评价先天性马蹄内翻足术后远期效果与生活质量的相关性。方法随访行肌力平衡术或Mckay术治疗的先天性马蹄内翻足患儿54例，共79足，男37例，女17例。手术时年龄5个月～3．5岁，平均1．2岁。平均随访13．2年（10～15年），对术后足的功能和生活质量进行评定。结果所有54例患儿，术后足的功能按Dimeglio评分，49例为优良，按自行设计的生活质量评分，48例为优良；术后足的功能与生活质量评分之间有明显的相关性（r=0．748，P〈0．001）。2种术式术后远期生活质量评分有显著的差异（P〈0．05）。结论先天性马蹄内翻足术后远期效果与生活质量具有相关性，Mckay术后患儿的生活质量优于肌力平衡术组，术后足的残余畸形是影响生活质量的主要因素。
Objective To access the long-term results of foot function and the quality of life （QOL） after the surgical treatment for congenital clubfoot （CCF）. Methods Fifty-four cases （37 males, 17 females） with CCF were followed-up for 10 to 15 years （the average of 13.2 years） after muscle strength balance operation or Mckay＇s procedure. The average age at operation was 1.2 years （ranging from 5 months to 3.5 years）. The Dimeglio＇s score of foot and QOL were investigated at the last follow-up. Results According to Dimeglio＇s score, the satisfactory rate was 90. 8%. The self- designed QOL investigation showed that 48 cases （88.9%） were satisfactory, and there was a significant correlation between Dimeglio＇s score and QOL score （r=0. 748, P 〈 0. 001）. The QOL scores were 5. 32±2. 36 in muscle strength balance operation group and 4.04±2. 06 in Mckay＇s procedure group, respectively （P = 0. 043）. Conclusions Most cases with CCF can be expected to achieve a long- term good or fair foot function and a high QOL after the operation. The QOL score correlates with Dimeglio＇s score significantly. The long-term QOL of patients in Mckay＇s procedure group are better than that in muscle strength balance operation group. The residual clubfoot deformity is the main factor influencing the long-term QOL.
