中医正骨
中醫正骨
중의정골
THE JOURNAL OF TRADITIONAL CHINESE ORTHOPEDICS AND TRAUMATOLOGY
2014年
11期
15-16
,共2页
王众%李骥%廖腾%吴亚乐
王衆%李驥%廖騰%吳亞樂
왕음%리기%료등%오아악
手损伤%软组织损伤%伤口缝合技术
手損傷%軟組織損傷%傷口縫閤技術
수손상%연조직손상%상구봉합기술
Hand injuries%Soft tissue injuries%Wound closure techniques
目的：观察改良 Kessler 缝合法治疗Ⅱ区指屈肌腱断裂的临床疗效和安全性。方法：Ⅱ区指屈肌腱断裂患者78例，随机分为2组，每组39例，分别采用改良 Kessler 缝合法和常规缝合法缝合断裂肌腱。术后观察2组患者肌腱愈合、患指功能恢复及并发症发生情况，并对2组的疗效和并发症发生率进行比较。结果：78例均获随访，随访时间3~6个月，依据中华医学会手外科学分会手部肌腱修复后评定标准评价疗效，改良 Kessler 缝合组，优25例、良11例、可2例、差1例；常规缝合组，优15例、良12例、可8例、差4例。改良 Kessler 缝合组疗效优于常规缝合组（Z =﹣2.654，p =0.008）。改良 Kessler 缝合组创面均一期愈合。常规缝合组，术后并发浅表感染2例，经换药愈合；并发深度感染1例，经拆除缝线、行负压封闭引流后愈合；并发肌腱再断裂2例，改行改良 Kessler 缝合后愈合。2组间并发症发生率比较，改良 Kessler 缝合组小于常规缝合组（ p =0.027）。结论：改良Kessler 缝合法治疗Ⅱ区指屈肌腱断裂，有利于肌腱愈合和患指功能恢复，并发症少，疗效优于常规缝合法。
目的：觀察改良 Kessler 縫閤法治療Ⅱ區指屈肌腱斷裂的臨床療效和安全性。方法：Ⅱ區指屈肌腱斷裂患者78例，隨機分為2組，每組39例，分彆採用改良 Kessler 縫閤法和常規縫閤法縫閤斷裂肌腱。術後觀察2組患者肌腱愈閤、患指功能恢複及併髮癥髮生情況，併對2組的療效和併髮癥髮生率進行比較。結果：78例均穫隨訪，隨訪時間3~6箇月，依據中華醫學會手外科學分會手部肌腱脩複後評定標準評價療效，改良 Kessler 縫閤組，優25例、良11例、可2例、差1例；常規縫閤組，優15例、良12例、可8例、差4例。改良 Kessler 縫閤組療效優于常規縫閤組（Z =﹣2.654，p =0.008）。改良 Kessler 縫閤組創麵均一期愈閤。常規縫閤組，術後併髮淺錶感染2例，經換藥愈閤；併髮深度感染1例，經拆除縫線、行負壓封閉引流後愈閤；併髮肌腱再斷裂2例，改行改良 Kessler 縫閤後愈閤。2組間併髮癥髮生率比較，改良 Kessler 縫閤組小于常規縫閤組（ p =0.027）。結論：改良Kessler 縫閤法治療Ⅱ區指屈肌腱斷裂，有利于肌腱愈閤和患指功能恢複，併髮癥少，療效優于常規縫閤法。
목적：관찰개량 Kessler 봉합법치료Ⅱ구지굴기건단렬적림상료효화안전성。방법：Ⅱ구지굴기건단렬환자78례，수궤분위2조，매조39례，분별채용개량 Kessler 봉합법화상규봉합법봉합단렬기건。술후관찰2조환자기건유합、환지공능회복급병발증발생정황，병대2조적료효화병발증발생솔진행비교。결과：78례균획수방，수방시간3~6개월，의거중화의학회수외과학분회수부기건수복후평정표준평개료효，개량 Kessler 봉합조，우25례、량11례、가2례、차1례；상규봉합조，우15례、량12례、가8례、차4례。개량 Kessler 봉합조료효우우상규봉합조（Z =﹣2.654，p =0.008）。개량 Kessler 봉합조창면균일기유합。상규봉합조，술후병발천표감염2례，경환약유합；병발심도감염1례，경탁제봉선、행부압봉폐인류후유합；병발기건재단렬2례，개행개량 Kessler 봉합후유합。2조간병발증발생솔비교，개량 Kessler 봉합조소우상규봉합조（ p =0.027）。결론：개량Kessler 봉합법치료Ⅱ구지굴기건단렬，유리우기건유합화환지공능회복，병발증소，료효우우상규봉합법。
Objective:To observe the clinical curative effects and safety of improved Kessler suture procedure in the treatment of finger flexor tendon rupture in zoneⅡ. Methods:Seventy ﹣ eight patients with finger flexor tendon rupture in zoneⅡwere randomly divided into 2 groups,39 case in each group. The patients in the 2 groups were treated with improved Kessler suture procedure and conventional suture procedure respectively for the ruptured tendon. Tendon healing,finger function recovery and complication were observed,and the curative effect and complication incidence were compared between the 2 groups. Results:All patients in the 2 groups were followed up for 3 ﹣ 6 months with a median of 4 months. According to the evaluation criteria for hand tendon repair issued by Hand Surgery Branch of Chinese Medical Association,25 patients obtained an excellent result,11 good,2 fair and 1 poor in the improved group,while 15 patients obtained an excellent result,12 good,8 fair and 4 poor in the conventional group. The curative effect was better in the improved group compared to the conventional group(Z = ﹣ 2. 654,p = 0. 008). The patients got primary healing in the operative incisions in improved group,while super in-cisions infection(2),deep incisions infection(1)and tendon re ﹣ breakage(1)were found in the conventional group. The complication rates were lower in the improved group compared to the conventional group(p = 0. 027). Conclusion:In the treatment of finger flexor tendon rup-ture in zoneⅡ,the improved Kessler suture procedure is conducive to tendon healing and finger functional recovery with few complications, and its curative effect is better than conventional suture procedure.
