足踝严重创伤性关节炎治疗中踝关节融合术的应用价值分析

Analysis of the Application Value of Ankle Arthrodesis in the Treatment of Severe Traumatic Arthritis of Athlete's Foot

目的探讨踝关节融合术在治疗足踝严重创伤性关节炎的应用价值。方法选取2015年9月—2017年7月该院收治的84例足踝严重创伤性关节炎患者,将患者随机对照组和观察组,每组42例,对照组患者给予开放性手术,观察组患者踝关节融合术。比较两组患者的手术时间、术时出血量、住院时长和治疗结束后的术后疼痛评分、足踝功能恢复情况和生活质量。结果观察组的手术时间、住院时长分别为(70.36±11.23)min和(7.38±2.38)d,短于对照组的(93.40±13.12)min和(9.29±2.10)d(t=8.646,3.900,P<0.05);观察组的术中出血量为(48.67±5.89)mL,少于对照组的(95.48±15.92)mL,差异有统计学意义(t=17.872,P<0.05)。观察组患者术后1 d和7 d的疼痛评分分别为(3.98±1.04)分和(1.56±0.62)分,均低于对照组的(5.14±1.25)分和(3.42±0.48)分,差异有统计学意义(t=4.623、15.373,P<0.05);术后6个月,观察组患者足踝功能的恢复优良率为88.1%,高于对照组的66.7%,差异有统计学意义(t=5.510,P<0.05)。结论踝关节融合术在治疗足踝严重创伤性关节炎时可缩短手术用时和住院时间,降低术中出血量,治疗效果更优,可加速恢复足踝创伤,改善患者的临床症状,值得推广使用。

Objective To investigate the value of ankle arthrodesis in the treatment of severe traumatic arthritis of athlete's foot.Methods 84 patients with severe traumatic arthritis of the foot and ankle were enrolled in the hospital from September 2015 to July 2017.The patients in the randomized control group and the observation group,42 patients in each group,and the control group were given open surgery.The observation group underwent ankle arthrodesis.The operation time,the amount of bleeding during surgery,the length of hospital stay,the postoperative pain score after treatment,the recovery of ankle function,and the quality of life were compared between the two groups.Results The operation time and hospitalization length of the observation group were(70.36±11.23)min and(7.38±2.38)d,respectively,which were shorter than the control group's(93.40±13.12)min and(9.29±2.10)d(t=8.646,3.900,P<0.05);the intraoperative blood loss of the observation group was(48.67±5.89)mL,which was less than the(95.48±15.92)mL of the control group,and the difference was statistically significant(t=17.872,P<0.05).The pain scores of the observation group were(3.98±1.04)points and(1.56±0.62)points,respectively,at 1 and 7 days after operation,which were lower than the(5.14±1.25)points(3.42±0.48)points of the control group,the difference was statistically significant(t=4.623,t=15.373,P<0.05).At 6 months after operation,the excellent and good rate of recovery of ankle function in the observation group was 88.1%,which was higher than that of the control group(66.7%).The difference was statistically significant(t=5.510,P<0.05).Conclusion Ankle arthrodesis can shorten the time and duration of surgery and reduce the amount of intraoperative blood loss in the treatment of severe traumatic arthritis of the foot.It can improve the recovery of athlete's foot and improve the clinical symptoms.It is worth promoting.