摘要
目的:探讨关节镜监视下冷融切松解手术治疗臀肌筋膜孪缩症的可行性及安全性。方法:自2004年7月至2006年2月,采用关节镜监视下冷融切治疗臀肌筋膜孪缩症患者22例(均为双侧,共44侧),男8例,女14例;平均年龄15(6～19)岁,均为轻至中度挛缩患者(无明显骨盆倾斜或骨盆后倾)。手术采用侧卧位,术前标志股骨大转子、臀肌挛缩带的手术入口,其中,大粗隆顶点前上3cm为进镜观察入路,大粗隆顶点后上3cm为出水管通道,大粗隆正上方7～8cm为等离子电极刀头入路。先于三点围成的区域内皮下注入50mm生理盐水,后上入路切开3～5mm,刨刀伸入皮下筋膜组织与臀肌挛缩带之间,刨去部分皮下筋膜组织,形成工作腔隙,生理盐水充盈后在关节镜监视下,以等离子电极斜行切断并松解挛缩带,并一边融切一边活动髋关节,直至无弹响、髋关节被动活动正常或接近正常水平,对于镜下可见的出血点以冷凝刀止血,手术结束从其中一入路放置细胶管引流一条。术后第一天拔除引流管,患者下地行走。结果:手术时间每侧20～40分钟,平均35分钟。术后引流量平均每侧10mm,伤口全部一期愈合,无血肿形成,无神经损伤并发症。平均随访6个月,功能恢复良好,臀部外观无明显凹陷。结论:关节镜监视下冷融切治疗臀肌筋膜孪缩症,具有操作安全、疗效可靠、创伤小、痛苦少、恢复快等优点,并无明显疤痕遗留,易于为患者接受。但本组患者均为轻型挛缩患者,对于严重挛缩患者有待于进一步经验积累和临床观察。
Objective To evaluate the effectiveness and security ofcoblation release under arthroscopy tor gluteal muscle fascia contraction syndrome. Methods From July 2004 to February 2006, 22 consecutive cases of gluteal muscle fascia contraction syndrome（bilateral） were operated by means of arthroscopic coblation release. Patients were in lateral position during operation. There were three portals for procedure located at the top of great trochenter. The patients were observed after operation and average 6 months postoperative follow-up to evaluate the effects and complications. Results The operating time was 20-40minutes （35minutes in average） for each side. Postoperative drainage 10ml in average for each side. There were no neurological involvement and incision complication. The patients showed delicate function and no disgraceful scar during follow-up. Conclusion Arthroscopic coblation release is a safe and effective minimal invasive surgical operation to loosen the gluteal muscle fascia contraction syndrome.
出处
《临床医学工程》
2008年第11期4-5,共2页
Clinical Medicine & Engineering
关键词
臀肌筋膜孪缩症
关节镜
冷融切技术
gluteal muscle fascia contraction syndrome
arthroscopy
coblation
