摘要
目的：探讨各种因素对关节镜下Nirschl清理术治疗顽固性网球肘疗效的影响。方法：回顾性分析2004年至2005年本所收治的关节镜下采用Nirschl清理术治疗的23例顽固性网球肘患者（24例肘：9例男性，14例女性；术时平均46．2岁）术后疗效。以视觉模拟评分法（visual ana1ogue scale，VAS）、重返工作和体育活动时间、满意度、肘关节活动范围和握力作为疗效的评价指标。用非参数检验或Fisher’s Exact检验分别比较性别、年龄、职业、病程、激素注射次数、术中是否使用缝合术或钻孔术对手术效果的影响。结果：术后随访时间平均12．6个月（4。23个月），随访率100％。手术总优良率87．5％。性别、年龄、职业、病程、激素注射次数、术中是否使用缝合术或钻孔术对手术效果均无明显影响。重体力劳动者与办公室工作者相比，前者（5．33个月）比后者（2．53个月）平均多2．8个月重返工作岗位，但两者差别无统计学意义（P=0．412）。结论：关节镜下Nirschl清理术是一种治疗顽固性网球肘安全有效的方法。性别、年龄、职业、病程、激素注射次数、术中是否使用缝合术或钻孔术对术后效果均无明显影响。
Objective To analyze the clinical outcome of arthroscopic Nirschl debridement for refractory lateral epicondylitis. Methods A retrospective analysis of 23 patients （24 elbows： 9 males; 14 females; aged 46.2 years averagely） who had been treated at our clinic between 2004 and 2005 was undertaken to evaluate the outcome of arthroscopic treatment. The patients received an average of 25.6 months （8 -72months） of conservative treatment before surgery. The VAS （visual analog scale ： 0 = no pain ; 10 = severe pain） scores, duration of return to work or sports, satisfaction, stiffness of elbow and grip strength were used as parameters of curative effect. Nonparametric test or Fisher＇ s Exact test was employed to analyze the relation of curative effect to the factors including sex ; age ; occupation of the patient; the time between the onset of symptoms and the operation ; the number of injections of corticosteroid ; suture or drilling in operation. Results The minimum follow- up period was 4 months （average： 12.6 months）, covered 100% of the patients. The curative effect in 87.5% of the patients was excellent or good, including 14 excellent （58.3%） and 7 good （29.2%）, 2 were fair （8.3%） and 1 was poor （4.7%）. There was no statistical significance between the outcome and the gender, age, occupation, time from onset of symptoms to the operation, the number of injection of corticosteroid, and suture or drilling in operation. Manual laborers workers took a longer time （average 2.8 months） to return to work as compared with the sedentary workers, however, this difference was not statistically significant （ P = 0.412）. There were no severe complications in this clinical setting. Conclusion Arthroscopic Nirschl debridement is a reliable technique for treating patients with refractory lateral epicondylitis. There was no relation of the postoperative results to the gender; age; occupation of the patient; time between the onset of symptoms and the operation; the number of injections
出处
《中国运动医学杂志》
CAS
CSCD
北大核心
2007年第4期444-447,共4页
Chinese Journal of Sports Medicine
