膝关节镜下ACL重建手术切口缝合的临床比较研究

Clinical Comparative Study of Incision Suture for ACL Reconstruction Under Knee Arthroscopy

目的对比美容缝合与传统缝合在膝关节镜下前交叉韧带(ACL)重建术伤口闭合中临床疗效及安全性。方法回顾性分析长海医院骨科2016年1月至2017年6月收治的膝关节镜手术患者,按纳入标准筛选出78例,并分为两组。其中,美容缝合组41例患者使用"皮内缝合+组织胶水"的方式关闭伤口,传统缝合组37例患者采用丝线普通缝合关闭伤口。比较两组患者住院时间、伤口缝合时间、伤口处理总成本、伤口愈合情况、患者伤口满意度、VAS评分、术后功能恢复情况等。结果两组住院时间、伤口处理总成本以及伤口愈合情况无显著差异(P>0.05),美容缝合组缝合时间长于普通缝合组(P<0.05);术后第1天、第7天、第14天美容缝合组VAS疼痛评分低于普通缝合组(P<0.05);术后第1周、第2周美容缝合组HSS评分高于普通缝合组(P<0.05),术后4周时两组评分相当(P>0.05)。结论在膝关节镜下前交叉韧带重建术中,使用皮内缝合结合组织胶水黏合的美容缝合方法,能够减轻患者术后疼痛,促进功能锻炼,改善伤口外观,增加患者满意度,达到加速早期康复的效果。

Objective Comparison of clinical efficacy and safety of cosmetic suture and traditional suture in(ACL)reconstruction of anterior cruciate ligament under arthroscopy.Method The patients undergoing knee arthroscopic surgery in the Department of Orthopaedics of Changhai Hospital from January 2016 to June 2017 were retrospectively analyzed.78 patients were selected according to the inclusion criteria and divided into two groups.Among them,41 patients in the cosmetic suture group used"intradermal suture+tissue glue"to close the wound,and 37 patients in the ordinary suture group used silk thread to close the wound.The length of stay,the time of wound suture,the total cost of wound treatment,wound healing,wound satisfaction,VAS score and postoperative functional recovery were compared between the two groups.Result There was no significant difference in hospitalization time,total cost of wound treatment and wound healing between the two groups(P>0.05).The suture time in cosmetic suture group was longer than that in ordinary suture group(P<0.05).On the 1 st,7 th and 14 th day after operation,the VAS pain score in the cosmetic suture group was lower than that in the ordinary suture group(P<0.05).The HSS score of the cosmetic suture group was higher than that of the common suture group at the first and second week after operation(P<0.05),and the scores of the two groups were the same at 4 weeks after operation(P>0.05).Conclusion In arthroscopic anterior cruciate ligament reconstruction,the cosmetic suture method of intradermal suture combined with tissue glue bonding can reduce postoperative pain,promote functional exercise,improve wound appearance and increase patient satisfaction and achieve the effect of accelerating early rehabilitation.