膝关节镜手术与切开手术治疗腘窝囊肿患者的效果比较

Comparison of effects of knee arthroscopic surgery and open surgery in treatment of popliteal cyst

目的:比较膝关节镜手术与切开手术治疗腘窝囊肿患者的效果。方法:回顾性分析2018年11月至2021年1月该院收治的70例腘窝囊肿患者的临床资料,按手术方式不同分为研究组36例与对照组34例。对照组采用传统切开手术治疗,研究组采用膝关节镜手术治疗,比较两组手术相关指标水平,术前、术后1个月囊液炎性因子[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,术前、术后6个月、术后1年Lysholm膝关节(Lysholm)评分,并发症发生率和术后1年复发率。结果:研究组手术时间、住院时间、术后首次下床时间、切口长度均短于对照组,术后24 h视觉模拟评分法评分低于对照组,差异有统计学意义(P<0.05);术后1个月,两组IL-6、TNF-α水平均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);术后6个月、1年,两组Lysholm评分均高于术前,且研究组高于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05);研究组复发率为2.78%(1/36),低于对照组的23.53%(8/34),差异有统计学意义(P<0.05)。结论:膝关节镜手术治疗腘窝囊肿患者可降低手术相关指标水平、囊液炎性因子水平和复发率,提高Lysholm评分,其效果优于切开手术治疗。

Objective: To compare effects of knee arthroscopic surgery and open surgery in treatment of popliteal cyst. Methods:The clinical data of 70 patients with popliteal cyst who underwent surgical treatment in the hospital from November 2018 to January 2021 were retrospectively analyzed. According to different surgical methods, they were divided into study group(36 cases) and control group(34 cases). The control group was treated with traditional open surgery, while the study group was treated with knee arthroscopic surgery. The levels of operationrelated indicators, the levels of inflammatory factors [interleukin-6(IL-6), tumor necrosis factor-α(TNF-α)] in cystic fluids before and 1 month after the surgery, the Lysholm knee joint(Lysholm) scores before and 6 months and 1 year after the surgery, the incidence of complications, and the recurrence rate 1 year after the surgery were compared between the two groups. Results: The operation time, the hospitalization time, the first out-of-bed time after the surgery and the incision length in the study group were shorter than those in the control group;the visual analogue scale score 24 h after the surgery was lower than that in control group;and the differences were statistically significant(P<0.05). 1 month after the surgery, the levels of IL-6and TNF-α in the two groups were lower than those before the surgery, those in the study group were lower than the control group, and the differences were statistically significant(P<0.05). 6 months and 1 year after the surgery, the Lysholm scores of the two groups were higher than those before the surgery, those of the study group were higher than those of the control group, and the differences were statistically significant(P<0.05). However,there was no significant difference in the incidence of complications between the two groups(P>0.05). The recurrence rate of the study group was 2.78%(1/36), which was lower than 23.53%(8/34) of the control group, and the difference was statistically significant(P<0.05). Conclusions: Knee arthroscopic surgery in the treatment of the patients with popliteal cyst can reduce the levels of operation related indicators, cyst fluid inflammatory factors and recurrence rate, and improve the Lysholm score. Moreover, it is superior to open surgery.