超声引导定位在膝关节镜手术中的应用效果

Application of ultrasound guided localization in knee arthroscopic surgery

目的研究超声引导定位在膝关节镜手术中的应用效果。方法将2020年1月至2021年2月期间于滨州医学院附属医院行膝关节镜手术治疗的200例膝关节疾病患者,通过随机数字表法分为传统组和超声组,各100例。传统组中,男55例,女45例,年龄(46.82±6.25)岁,采用传统解剖定位法建立膝关节镜前外侧通道;超声组中,男53例,女47例,年龄(46.48±5.64)岁,采用超声引导下定位法建立膝关节镜前外侧通道。采用t、χ^(2)检验比较两组患者手术时间、关节内组织损伤并发症发生率、术后7 d和14 d的视觉模拟量表(VAS)评分。结果超声组手术时间为(68.96±21.09)min,低于传统组[(76.17±23.45)min],两组比较,差异有统计学意义(t=-2.286,P<0.05)。超声组术中操作导致关节内组织损伤并发症发生率为3%(3/100),低于传统组的10%(10/100),两组比较,差异有统计学意义(χ^(2)=4.031,P<0.05)。超声组术后7、14 d的VAS评分分别为(3.78±1.00)分、(1.68±0.71)分,均低于传统组[(4.67±0.94)分、(2.54±0.69)分],两组比较,差异均有统计学意义(t=-6.485、-6.686,均P<0.001)。结论对于行膝关节镜手术的患者,术中采用超声引导定位法建立前外侧通道可减少关节内组织损伤并发症发生率及手术时间,减轻患者术后早期疼痛,值得推广。

Objective To study the effect of ultrasound guided localization in knee arthroscopic surgery.Methods Two hundred patients with knee joint diseases who underwent knee arthroscopic surgery in Binzhou Medical University Hospital from January 2020 to February 2021 were divided into a traditional group and an ultrasonic group by the random number table method,with 100 patients in each group.The traditional group had 55 males and 45 females who were(46.82±6.25)years old;the anterolateral channels of knee arthroscopy were established by the traditional anatomical positioning method in the traditional group.The ultrasonic group had 53 males and 47 females who were(46.48±5.64)years old;the anterolateral channels of knee arthroscopy were established by the ultrasound guided positioning method in the ultrasonic group.The operation times,incidences of intra-articular tissue injury,and pain scores of Visual Analogue Scale(VAS)7 and 14 days after the operation were compared between the two groups by t and χ^(2) tests.Results The operation time in the ultrasonic group was shorter than that in the traditional group[(68.96±21.09)min vs.(76.17±23.45)min],with a statistical difference(t=-2.286,P<0.05).The incidence of intra-articular tissue injury caused by operation in the ultrasonic group was lower than that in traditional group[3%(3/100)vs.10%(10/100);(χ^(2)=4.031,P<0.05)].The VAS scores 7 and 14 days after the operation in the ultrasound group were lower than those in the traditional group[(3.78±1.00)vs.(4.67±0.94)and(1.68±0.71)vs.(2.54±0.69)],with statistical differences between the two groups(t=-6.485 and-6.686,both P<0.05).Conclusion For patients undergoing knee arthroscopic surgery,the establishment of anterolateral channels with ultrasound guided localization during the operation can reduce the operation time,the incidence of intra-articular tissue injury,and the patients'early postoperative pain,so it is worthy of promotion.