关节镜手术治疗后足骨样骨瘤的临床疗效

Efficacy of arthroscopic surgery for osteoid osteoma in the hind foot

目的探讨关节镜手术治疗后足骨样骨瘤的临床效果。方法选取2013年10月至2015年10月间临朐县人民医院收治的23例后足骨样骨瘤患者,均行关节镜手术,观察患者手术时间和术前、术后3d、术后1周、术后3个月、术后12个月及术后18个月的疼痛评分,并比较患者治疗前后的AOFAS踝后足评分。结果患者均顺利完成手术,手术时间为20~45(29.56±3.45)min,术后患者未出现明显的不适感,术前患者疼痛评分为(7.45±2.12)分,术后3d、术后1周、术后3个月、术后12个月和术后18个月患者的疼痛评分分别为(3.56±0.45)分、(0.65±0.27)分、(0.54±0.25)分、(0.53±0.20)分和(7.45±2.12)分,术后各时间点与术前比较,疼痛评分均降低,差异均有统计学意义(均P<0.05)。随访时间为4~22(14.5±0.4)个月,期间无患者出现伤口感染、肺部感染和肿瘤复发等。术前患者AOFAS踝-后足评分为(40.56±3.2)分,术后为(90.54±6.77),两组比较,差异有统计学意义(P<0.05)。结论关节镜手术治疗足骨样骨瘤的近期效果较好,对周围组织损伤较小,安全性高,患者耐受性较好。

Objective To explore and analyze efficacy of arthroscopic surgery for osteoid osteoma in the hind foot. Methods Clinical data was selected from 23 patients with osteoid osteoma in the hind foot admitted to Linqu County People＇s Hospital from October 2013 to October 2015. Duration of surgery and score of pain at 3 d before and after the surgery and at 1 week, 3 months, 12 months and 18 months after the surgery were summarized. Clinical efficacy was compared between the two groups before and after the surgery. Results All the patients successfully completed arthroscopic surgery and surgery duration was 20 - 45 （29. 56 ± 3.45 ） min. Postoperative obvious discomfort did not occur in patients. Preoperative pain score was （7.45 ±2. 12） points before the surgery. At 3 d, 1 week, 3 months, 12 months and 18 months after the surgery, pain score was （3.56 ± 0.45） points, （0. 65 ± 0. 27） points, （0. 54 ± 0. 25） points, （0. 53 ±0. 20） points and （7.45 ± 2. 12） points, respectively, which decreased at each time point com- pared with before the surgery （ all P 〈 0. 05 ）. During the follow-up of 4 ± 22 months, no patients experi- enced wound infection, pulmonary infection or tumor recurrence. American Orthopaedic Foot and Ankle So- ciety （AOFAS） ankle-hindfoot score was （ 40. 56 ± 3.2 ） points before the surgery and （ 90. 54 ± 6. 77 ） points after the surgery （ P 〈 O. 05 ）. Conclusion Arthroscopic surgery for osteoid osteoma in the hind foot shows good short-term efficacy, which is minimally invasive with little damage to the surrounding tissues, high safety and good tolerance.