关节镜手术治疗踝关节撞击综合征的临床效果

Clinical effect of arthroscopic surgery in the treatment of ankle impingement syndrome

目的探讨关节镜手术治疗踝关节撞击综合征的临床效果。方法回顾性分析南京医科大学第一附属医院2018年1月至2019年10月收治的50例踝关节撞击综合征患者的临床资料,所有患者均采用关节镜手术治疗且获得随访,随访至2020年4月,随访时间为6~27个月,平均17.56个月。观察患者术后6个月的疗效和并发症发生情况,比较术前、术后6个月和随访末患者的视觉模拟评分法(visual analogue scale,VAS)评分、美国矫形外科足踝协会(American Orthopaedic Foot and Ankle Society,AOFAS)踝关节功能评分和生活质量。结果 50例踝关节撞击综合征患者均完成关节镜手术和随访,治疗优良率为94.00%。所有患者术后均未出现血管和神经损伤,无一例感染。术后6个月和随访末VAS评分均显著低于术前(均P<0.05),AOFAS踝关节功能评分、生活质量核心量表(quality of life questionary-core 30,QLQ-C30)各项评分均显著高于术前(均P< 0.05);术后6个月和随访末VAS评分、AOFAS踝关节功能评分、QLQ-C30各项评分比较差异均无统计学意义(均P>0.05)。结论关节镜手术治疗踝关节撞击综合征效果良好,可减轻疼痛,改善患者踝关节功能和生活质量。

Objective To explore the clinical effect of arthroscopic surgery in the treatment of ankle impingement syndrome.Method A retrospective analysis was made of 50 patients with ankle impingement syndrome admitted in the First Affiliated Hospital with Nanjing Medical University from January 2018 to October 2019,all of whom were treated with arthroscopic surgery,all patients were followed up to April 2020,with a mean follow-up period of 17.56 months,ranged from 6~27 months.The curative effect and complications were observed 6 months after operation.The visual analogue score(VAS)score,American Orthopaedic Foot and Ankle Society(AOFAS)ankle joint function score and quality of life of preoperation,postoperative 6 months and end of follow-up were compared.Result Arthroscopic surgery and follow-up were completed in 50 patients with ankle impingement syndrome.The excellent and good rate was 94.00%.All the patients had no vascular or nerve injury after operation,and no infection.The VAS scores at 6 months after operation and the end of follow-up were significantly lower than that in preoperation(all P<0.05),the AOFAS ankle function score,the scores of different items in quality of life questionary-core 30(QLQ-C30)were significantly higher than that in preoperation(all P<0.05),there were no significant differences in VAS score,AOFAS ankle joint function score,the scores of different items in QLQ-C30 between the 6 months after operation and the end of follow-up(all P>0.05).Conclusion Arthroscopic surgery is effective in the treatment of ankle impingement syndrome,and it can reduce the pain,improve the ankle function and the quality of life of patients.