【摘要】 目的 探究球窝假体关节成形术(SPA)对第一腕掌(TMC)骨关节炎患者腕关节功能及上肢活动功能的影响。方法 选取2020年9月至2021年12月三门峡市中心医院收治的符合手术指征且接受SPA治疗的113例TMC骨关节炎患者作为研究对象。统计患者围手术期情况、比较术前及术后3个月视觉模拟量表(VAS)评分、手功能(握力、捏力、桡侧外展、掌侧外展)、腕关节功能(Krimmer量表评分)、上肢功能评定表(DASH)评分、日常活动能力(ADL)评分、生活质量综合评定问卷-74(GQOLI-74)评分。结果 113例患者手术时间71～100(79.53±3.86)min;术中出血量5～20(11.72±2.94)mL;住院时间8～15(11.74±1.49)d;术后均未出现神经损伤、假体脱位、血栓栓塞等并发症，出现感染6例，患肢肿胀3例，经保守治疗后恢复，切口愈合率为100%(113/113);术后3个月腕关节恢复优良率为97.35%(110/113);术后3个月VAS评分低于术前(P<0.05);术后3个月握力、侧捏力、掌侧外展、桡侧外展均较术前改善(P<0.05);术后3个月Krimmer评分高于术前，DASH评分低于术前(P<0.05);术后3个月ADL、GQOLI-74评分均较术前改善(P<0.05)。结论 SPA治疗TMC骨关节炎患者效果确切，能有效增强关节稳定性，改善腕关节功能，减轻患者疼痛，提高手指活动度，缓解上肢活动功能受限，有助于增强日常生活能力，提高生活质量。更多还原

【Abstract】 Objective To investigate the effects of spherical fossa prosthesis arthroplasty(SPA) on wrist function and upper limb mobility in patients with osteoarthritis of the trapeziometacarpal(TMC) joint.Methods From September 2020 to December 2021, 113 patients with TMC osteoarthritis who met the surgical indications and received SPA treatment in Sanmenxia Central Hospital were selected as the study subjects. The patients’ perioperative conditions were counted, and the preoperative and 3-month postoperative visual analog scale(VAS) scores, hand function(grip strength, pinch strength, radial abduction, palmar abduction), wrist function(Krimmer scale scores), disability of arm, shoulder and hand(DASH) scores, ADL(activities of daily living) score, and general quality of life inventory-74(GQOLI-74) score were compared.Results The operation time of 113 patients was 71-100(79.53±3.86) min. The intraoperative bleeding volume was 5-20(11.72±2.94) mL. The hospital stay was 8-15(11.74±1.49) days. There were no complications such as nerve injury, prosthesis dislocation and thromboembolism after operation. There were 6 cases of infection and 3 cases of limb swelling. After conservative treatment, the wound healing rate was 100%(113/113). The excellent and good rate of wrist joint recovery 3 months after operation was 97.35%(110/113). The VAS score at 3 months after operation was lower than that before operation(P<0.05). The grip strength, lateral pinch strength, palmar abduction and radial abduction were improved 3 months after operation(P<0.05). Three months after operation, Krimer score was higher than that before operation, and DASH score was lower than that before operation(P<0.05). ADL and GQOLI-74 scores improved 3 months after operation compared with those before operation(P<0.05).Conclusion SPA has a definite effect on TMC osteoarthritis patients. It can effectively enhance joint stability, improve wrist function, relieve pain, improve finger range of motion, relieve upper limb function limitation, and help to enhance the ability of daily life and improve the quality of life.更多还原