弹力绷带应用于军事训练伤致半月板撕裂合并腘窝囊肿围术期的临床研究

Clinical study on the application of elastic bandage in meniscus injury with popliteal cyst

目的探讨弹力绷带对半月板训练伤合并腘窝囊肿关节镜术后关节积液的控制效果。方法选取经我院自2020年1月30日至2021年1月30日收治的训练伤致半月板损伤同时合并腘窝囊肿的战士64例,全部病例均在关节镜下行半月板部分切除缝合、腘窝囊肿切除术。按随机数字表法分为两组:A组为弹力绷带组(弹力绷带缠绕患肢),B组为无菌敷料组(无菌敷料覆盖切口)。通过比较两组术后第2天、4天、7天、14天、28天和第6个月的双膝髌骨上缘10 cm处的周径差、膝关节活动度(ROM)、视觉模拟评分(visual analogue scale,VAS)、末次随访的Lysholm评分和末次MRI检查评估弹力绷带的疗效和囊肿复发情况。结果两组术前相关评价指标相比差异无统计学意义。术后第2天膝关节周径差A组低于B组(1.70±0.20)vs.(2.28±0.26),术后第4天膝关节周径差A组低于B组(1.64±0.14)vs.(2.19±0.23),术后第7天膝关节周径差A组低于B组(1.44±0.19)vs.(1.90±0.23),术后第14天膝关节周径差A组低于B组(1.10±0.22)vs.(1.78±0.31),术后第28天膝关节周径差A组低于B组(0.93±0.28)vs.(0.98±0.25),差异有统计学意义(P<0.05);术后6个月周径差值两组相比差异无统计学意义(P>0.05);术后第2天膝关节ROM A组优于B组(44.34±12.51)vs.(35.84±12.10)、术后第4天膝关节ROM A组优于B组(55.95±8.25)vs.(48.56±10.71)、术后第7天膝关节ROM A组优于B组(80.33±6.65)vs.(73.92±7.30),差异有统计学意义(P<0.05);第14天、28天和6个月ROM两组相比,差异无统计学意义(P>0.05);术后不同时间VAS评分分值,两组相比差异均无统计学意义(P>0.05);末次随访Lysholm评分A组高于B组(76.8±7.63)vs.(65.73±4.96),差异有统计学意义(P<0.05)。结论弹力绷带对半月板损伤合并腘窝囊肿术后膝关节积液的产生可起到一定的抑制作用,利于术后早期的康复训练和远期膝关节功能的恢复。

Objective To investigate the control effect of elastic bandage on joint effusion after meniscus training injury combined with popliteal cyst.Methods A cohort of 64 soldiers with meniscus injury and popliteal cyst were admitted to our hospital from January 30,2020 to January 30,2021.All patients underwent partial meniscectomy and suture and popliteal cyst resection under arthroscopy.According to the random number table method,all patients were divided into two groups.Group A,elastic bandage group(elastic bandage was wrapped around the affected limb);Group B,sterile dressing group(sterile dressing covered incision).The curative effect of elastic bandage and the recurrence of cyst were evaluated by comparing the peripheral difference 10cm at the upper margin of the patella,knee joint range of motion(ROM),VAS score,Lysholm score at the last follow-up,and magnetic resonance imaging(MRI)at the last follow-up between the two groups on day 2,day 4,day 7,day 14,day 28,and 6 months after operation.Results There was no significant difference in preoperative evaluation indexes between the two groups.The difference of knee circumference in group A was significantly lower than that in group B on the 2nd(1.70±0.20)vs.(2.28±0.26),4th(1.64±0.14)vs.(2.19±0.23),7th(1.44±0.19)vs.(1.90±0.23),14th(1.10±0.22)vs.(1.78±0.31)and 28th(0.93±0.28)vs.(0.98±0.25)day after operation(P<0.05);there was no statistically significant difference between the two groups in the difference of circumference at 6 months after operation(P>0.05);ROM of knee joint in group A was better than that in group B on the 2nd(44.34±12.51)vs.(35.84±12.10),4th(55.95±8.25)vs.(48.56±10.71)and 7th(80.33±6.65)vs.(73.92±7.30)days after operation(P>0.05);there was no significant difference in ROM between the two groups on day 14,28 and 6 months(P<0.05);there was no significant difference in VAS scores at different observation points(P>0.05);group A had statistically significant higher Lysholm score(76.8±7.63)vs.(65.73±4.96)than group B(P<0.05).Conclusions Elastic bandage could inhibit the generation of knee joint effusion after meniscus injury combined with popliteal cyst,which is conducive to early postoperative rehabilitation training and long-term recovery of knee joint function.