关节镜下关节松解术对不同情况肘关节僵硬患者的疗效观察

Observation of curative effect of arthroscopic arthrolysis in patients with elbow stiffness under different conditions

目的评估创伤性与非创伤性肘关节僵硬患者接受关节镜下关节松解前及术后1年临床活动范围、功能、疼痛程度及生活质量。方法回顾性分析了复旦大学附属华山医院2018年1月至2021年1月期间接受关节镜肘关节松解术的患者94例(创伤性50例,非创伤性44例),并完成至少1年的随访,分别评估两组患者手术前后临床活动范围、功能、疼痛程度及生活质量的变化。临床活动范围用伸肘角度,屈肘角度以及肘关节活动度(range of motion,ROM)评估;功能用Mayo肘关节功能评分(mayo elbow performance index,MEPS)评估;疼痛程度用疼痛视觉模拟评分(visual analogue scale,VAS)评估;36条目健康调查简表(36-item short-form health survey,SF-36)用于评估术后患者的生活质量。结果与术前相比,创伤性与非创伤性肘关节僵硬患者术后临床活动范围、功能、术后疼痛程度均有明显改善(均P<0.05)此外,两组患者术后SF-36各项评分也显著提高(均P<0.05)。结论关节镜下关节松解术是治疗创伤后和非创伤性肘部僵硬患者的有效工具和良好选择,除积极改善肘部活动范围功能外,还应重视患者的心理健康状况及时开展心理干预。

Objective To evaluate the clinical range of motion,function,pain level and quality of life in patients with traumatic and nontraumatic elbow stiffness before and 1 year after arthroscopic arthrolysis.Methods A retrospective analysis of 94 patients(traumatic 50 cases;non-traumatic 44 cases)who underwent arthroscopic elbow joint release between January 2018 and January 2021 and completed at least 1 year of follow-up,assessed separately Changes in clinical range of motion,function,pain level and quality of life before and after surgery in both groups.The clinical range of motion was assessed by elbow extension angle,elbow flexion angle,and elbow range of motion(ROM);function was assessed by Mayo Elbow Performance Index(MEPS);Pain level was assessed by pain visual analog scale(VAS)assessment;Using 36-item short-form health survey(36-item short-form health survey,SF-36)to assess the quality of life of patients.Results Compared with preoperative ones,the postoperative clinical range of motion,function,and postoperative pain in patients with traumatic and nontraumatic elbow stiffness were significantly improved(allP<0.05).Item scores were also significantly improved(all P<0.05).Conclusion Arthroscopic arthrolysis is an effective tool and a good choice for the treatment of post-traumatic and non-traumatic patients with elbow stiffness.In addition to actively improving the function of the elbow range of motion,educational and psychological interventions should be carried out according to the specific conditions of the patients.