小切口手术在拇指狭窄性腱鞘炎患儿中的应用效果

Application Effect of Small Incision Surgery in the Children with Stenosing Tenovaginitis of Thumb

目的:探究小切口手术在拇指狭窄性腱鞘炎患儿中的应用效果。方法:将2021年6月—2023年12月福州市第一总医院儿童专科院区的180例拇指狭窄性腱鞘炎患儿根据随机数字表法分为对照组(90例)和观察组(90例)。对照组进行传统手术治疗,观察组则进行小切口手术治疗。比较两组的总优良率、手术时间、术中出血量、并发症发生率、手术前后的疼痛程度[面部表情疼痛评估量表(FPS-R)评分]及患指功能(拇指活动度、手指捏力、拇指对指功能评分及握力)。结果:观察组的总优良率高于对照组,手术时间短于对照组,术中出血量少于对照组,并发症发生率低于对照组,差异均有统计学意义(P<0.05)。术前两组的FPS-R评分构成及患指功能指标比较,差异均无统计学意义(P>0.05),术后1周及4周,观察组的FPS-R评分构成优于对照组,术后3个月观察组的拇指活动度、手指捏力、拇指对指功能评分及握力均高于对照组,差异均有统计学意义(P<0.05)。结论:小切口手术在拇指窄性腱鞘炎患儿中的疗效较好,且可有效控制患儿疼痛及改善患指功能。

Objective:To investigate the application effect of small incision surgery in the children with stenosing tenovaginitis of thumb.Method:A total of 180 children with stenosing tenovaginitis of thumb in Children's Specialized Hospital Area of Fuzhou First General Hospital from June 2021 to December 2023 were divided into control group(90 cases)and observation group(90 cases)according to random number table method.The control group was treated with traditional surgery,the observation group was treated with small incision surgery.The total excellent and good rates,operation time,intraoperative blood loss,complication rates,pain degree[faces pain scale revision(FPS-R)score]and affected finger function(thumb range of motion,finger pinch strength,thumb-to-finger function score and grip strength)before and after the surgery were compared between the two groups.Result:The total excellent and good rate of observation group was higher than that of control group,the operation time was shorter than that of control group,the intraoperative blood loss was lower than that of the control group,and the complication rate was lower than that of the control group,the differences were statistically significant(P<0.05).There were no statistical significance in the FPS-R score composition and the affected finger function indexes between the two groups before surgery(P>0.05).The FPS-R score composition of the observation group were better than that of the control group at 1 week and 4 weeks after surgery,and the thumb range of motion,finger pinch strength,thumb-to-finger function score and grip strength of the observation group were higher than those of the control group at 3 months after surgery,the differences were statistically significant(P<0.05).Conclusion:The effect of small incision surgery in the children with stenosing tenovaginitis of thumb is better,and it can effectively control the pain and improve the affected finger function of children.