中西医结合治疗膝关节术后纤维粘连

Integrative Medicine Therapy for Knee Joint Adhesion after Operation

目的：探讨中药熏洗结合关节镜微创手术治疗膝关节术后关节内纤维粘连的方法和疗效。方法：治疗组17例膝关节粘连患者,年龄17-57岁,平均34.8岁。术前1周中药熏洗,关节镜下松解髌上囊、髁间窝及双侧隐窝的粘连,术后第2天CPM机开始功能锻炼,拆线1周后中药熏洗。结果：随访6个月-1年。疗效评定按Judet疗效评定法,优14例,良2例,可1例。平均较术前改善70.5°。无一例患者出现伤口感染和皮肤坏死等并发症。结论：中药熏洗结合关节镜微创手术治疗膝关节术后关节内纤维粘连具有创伤小、术后疼痛轻、并发症少、康复快,符合中医辨证等优点,是治疗膝关节粘连的有效方法。

Objective： To investigate the method and efficacy of Chinese herb fumigation and washing combined with arthroseopic surgery for knee joint adhesion after operation. Methods： A total of 17 patients with knee joint adhesion, aged 17 - 57 years and mean age of 34.8 years, were selected in the experiment. The Chinese herb fumigation and washing was performed one week before operation. The adhesions of suprapatellar bursa, intereondylar fossa and bilateral recesses were released under arthroscopy. Functional exercise was performed by using continuous passive motion （CPM） machine from the 2nd day after operation. The Chinese herb fumigation and washing was performed again one week after stitch re- moval. Result： All patients were followed up for 6 - 12 months. Efficacy was evaluated according to Judet method： 14 cases were excellent, 2 cases were good, and 1 case was passable. There is no complications of wound infection and skin necrosis. Conclusion： Chinese herb fumigation and washing combined with arthroscopic surgery for knee joint adhesion has advantages of small trauma, little pain, less complications, quick recovery, and in accordance to traditional Chinese medicine syndrome differentiation, which is a good treatment for knee joint adhesion.