不同手术切口治疗臀肌挛缩症疗效比较

Comparison of efficacy of different surgical incision in treatment of gluteal muscle contracture

目的探讨不同手术切口治疗臀肌挛缩的临床疗效。方法 2009年10月至2011年11月手术治疗臀肌挛缩症患者149例,其中86例接受横形直切口(A组),63例接受纵弧形切口(B组)。术中均充分切断挛缩带,术后两组患者均接受同一康复训练模式。对两组术后引流量、术后伤口愈合情况、术后髋关节功能进行统计学分析。结果术后随访12～18个月,A、B组患者均获甲级愈合,无伤口感染发生;24 h引流量A组少于B组(P=0.016)、48 h引流量无差异(P=0.383);术后所有患者髋关节功能改善明显,两组间髋关节功能评分差异无统计学意义(P>0.05),两组疗效优良率比较无明显统计学差异(P>0.05)。结论手术治疗是臀肌挛缩症首选治疗方法,术后疗效好,恢复均满意。不同手术切口治疗臀肌挛缩症不会影响疗效。

Objective To explore the clinical efficacy of different surgical incision methods in the treatment of gluteal muscle contracture. Methods From October 2009 to November 2011, 149 patients with gluteal muscle contracture were divided into two groups and underwent operations with two different surgical incision methods （group A： straight horizontal incision for 86 cases, group B： curved longitudinal incision for 63 cases）. During surgery, the patient＇s degenerative contracture parts was fully cut off, the contracture tissue was completely released. All patients accepted the same rehabilitation training method after operation. The amount of postoperative drainage, wound healing effect and postoperative hip functions of the two groups were then compared and analyzed. Results All cases were followed up for 12-18 months after operation, and all the wounds were examined healing well without infections for both groups. Twenty four hours drainage volume in A group was less than in group B （P = 0. 016）, no difference between the two groups at 48 hours drainage （P = 0. 383）. Significant improvements of hip functions were observed after operation for all cases. No significant differences were found in postoperative hip function scores between the two groups （P~〉0.05）. Conclusions Surgery is the preferred method of treatment for muscle contracture. Satisfied clinical efficacy can be obtained by both surgical incision methods （straight horizontal incision and curved longitudinal incision） and no significant differences in clinical efficacy were found between the two methods for the treatment of gluteal muscle contracture.