内窥镜下手术治疗四肢皮下血肿

Endoscope techniques for subcutaneous hematoma in the limbs

目的 对四肢皮下血肿行内窥镜下手术治疗的效果进行初步探讨。 方法 1998年 3月～ 2 0 0 1年 10月 ,内窥镜下手术治疗四肢陈旧性皮下血肿 7例 ,其中皮下血肿位于股部外侧2例 ,膝关节内侧 1例 ,外伤性髌前滑囊血肿 1例 ,胫骨前方 3例。血肿面积最大 2 0cm× 5cm ,最小4cm× 6cm。 结果 全部病例均获得随访 ,随访时间 3～ 16个月。患者术后均获得良好愈合 ,皮肤和深层组织无瘢痕残留 ,无疼痛及功能障碍。 结论 四肢较大的皮下血肿内窥镜下手术治疗 ,体表切口小 ,瘢痕少 ,操作准确 ,术后反应轻 ,恢复快 ,可取得与开放手术同样的效果 ,避免了传统治疗方法的缺点。对于直径 >5cm或硬性的皮下血肿 ,内窥镜下手术治疗可作为首选。

Objective To preliminarily evaluate the effect of endoscopy in treatment of subcutaneous hematoma in the limbs. Methods From March 1998 to October 2001, endoscope techniques were ferformed in 7 cases of old subcutaneous hematoma, among which were 2 cases of subcutaneous hematoma on the lateral femur, 1 on the medial knee joint, 1 on the traumatic prepatellar bursa and 3 on the anterior tibia. The area of the biggest hematoma was 20 cm×5 cm and that of the smallest 4 cm×6 cm. Results All the patients were followed up with a time range of 3-16 months and got sound healing with no scar in the skin and deeper tissues, pain or dysfunction. Conclusions The endoscope for larger subcutaneous hematoma in the limbs has the advantages such as smaller incision, less scar, accurate manipulation,mild postoperative reaction and fast recovery. Therefore, it can not only obtain similar curative effect to that of the traditional open operation but also avoid the shortcomings of the traditional operation. Endoscope techniques should be the first alternative to hematoma of over 5 cm or hard subcutaneous hematoma in the limbs.