【作者】 徐斌；

【导师】 吕佳音；

【作者基本信息】 吉林大学 ， 外科学（专业学位）， 2021， 硕士

【摘要】 目的:通过膝关节内侧副韧带损伤后非手术治疗及手术治疗的对比,探讨膝关节内侧副韧带损伤的不同治疗方案,为临床医师的治疗措施选择提供依据。资料及方法:以2018年1月至2020年1月我院诊治的42例膝关节内侧副韧带Ⅲ度损伤患者为研究对象,且随访时间不小于10个月,根据治疗方式分为保守治疗组和手术治疗组。保守治疗组病例数为18例,手术治疗组病例数为24例。所有患者治疗措施均由同一高年资医生完成。于手术治理后及非手术治疗后分别采用(IKDC)膝关节评估表、Lysholm评分、视觉模拟量表(VAS)评分、膝关节活动度ROM来评估患者膝关节内侧副韧带损伤恢复状况。采用SPSS26统计软件进行数据分析,计量资料以(?)±s(均数±标准差)表示,采用独立样本t检验比较两组患者治疗结果,采用配对t检验比较同组患者不同时间的治疗结果,P<0.05认为差异有统计学意义,检验水平为α=0.05。结果:两组患者均得到了有效随访,其年龄、性别、左右侧别等一般资料比较,差异无统计学意义(P>0.05)。治疗前,治疗后2个月,3个月及末次复查时两组VAS评分差异无统计学意义(P>0.05),但在治疗后早期1周及1月复查时,手术组患者VAS分值高于非手术治疗组患者VAS分值,且差异有统计学意义(P<0.05)。手术组患者与非手术组患者在各自采取治疗措施前,及治疗后2个月、3个月膝关节活动度差异无统计学意义(P>0.05),治疗早期1月时膝关节ROM有统计学意义(P<0.05)。采取治疗措施前两组患者IKDC评分的差异无统计学意义(P>0.05),末次随访时手术组病人膝关节IKDC评分高于非手术治疗组病人的IKDC评分,且差异有统计学意义(P<0.05)。患者就诊时两组患者Lysholm评分差异无统计学意义(P>0.05),在末次随访中,手术组患者Lysholm评分高于非手术治疗组患者,且差异有统计学意义(P<0.05)。结论:1.保守治疗患者早期VAS分值较手术治疗患者评分低。2.保守治疗患者早期膝关节活动度ROM优于手术治疗患者。3.保守治疗及手术治疗均对内侧副韧带损伤患者均有治疗效果。4.手术组患者治疗后的各项膝关节功能评分及膝关节功能的优良率均高于保守组患者。更多还原

【Abstract】 Objective:Through the comparative analysis of conservative treatment and surgical treatment after medial collateral ligament injury,it provides reference for clinical treatment of medial collateral ligament injury of knee.Methods:A total of 42 patients with medial collateral ligament injury of the knee admitted to the China-Japan Union Hospital of Jilin University from January 2018 to January 2020 were selected as the study subjects,and the follow-up time was no less than 10 months.They were divided into the nonoperative treatment group and the repaired treatment group.There were 18 cases in the nonoperative treatment group and 24 cases in the repaired treatment group.All patients were given physical therapy instruction and surgical operation by the same senior doctor.The International Knee Documentation Committee score(IKDC),Lysholm score,visual analogue scale(VAS)score,and range of motion of knee(ROM)were used to evaluate the recovery of the medial collateral ligament injury of the knee after surgery and after physical therapy.Use IBM SPSS26 statistical software for statistical data analysis,measurement data to (?)+ s(standard deviation),We use the independent sample t test to compare two groups of patients as a result,the paired t test to compare different time of the same group as a result,If P < 0.05,the difference was statistically significant,inspection level is α= 0.05.Results:Patients in both groups were effectively followed up.General data such as age,sex and left and right gender were compared,showing no statistically significant difference(P>0.05).Before treatment,there was no statistically significant difference in VAS scores between the two groups at 2 months,3 months or at the last review(P>0.05).However,the VAS score of the operation group was higher than that of the nonoperation treatment group at the early 1 week and 1 month review,and the difference was statistically significant(P<0.05).There was no statistically significant difference in range of motion between the two groups before and 2 and 3 months after treatment(P>0.05),ROM of knee had statistical significance at the early 1 month of treatment(P<0.05).IKDC scores of patients in the two groups before treatment showed no statistical significance(P>0.05).At the last follow-up,IKDC score of the operative group was higher than that of the nonoperative group,and the difference was statistically significant(P<0.05).Before treatment,there was no statistically significant difference in Lysholm scores between the two groups(P>0.05).At the last follow-up,Lysholm score in operative group was higher than that in the nonoperative group,and the difference was statistically significant(P<0.05)Conclusion:1.To compare the VAS score the patients in operative group was better than that in nonoperative group,in the early stage.2.In early stage,the patients in operative group performed better motion of knee than that in nonoperative group.3.For all the patients with medial collateral ligament injury,both groups had effective treatment.4.After treatment,IKDC score,Lysholm score and excellent and good rate based on Lysholm score in the operative group were all higher than those in the nonoperative group.更多还原