摘要
目的 分析总结近 20年来关节镜手术并发症的原因，并提出具体的预防措施。 方法 自 1980年 5月～ 1999年 5月共施行关节镜手术 1 540例，病变部位分别为膝关节 (1 426例 )、踝关节 (59例 )、腕关节 (17例 )、第一跖趾关节 (21例 )、髋关节 (8例 )、肘关节 (6例 )、肩关节 (3例 )。结果 在施行关节镜检查或术中、术后发生各种并发症及意外者 79例 (5.1％ )，其中发生关节内各种器械断裂 8例，关节内正常组织损伤 40例，关节镜入孔周围组织结构损伤 11例，冲洗液外渗 13例，关节血肿、感染 5例，术中髌骨再骨折 1例，术后突发心肌梗死 1例。结论 关节镜检查或镜下手术时发生并发症及意外的原因主要由于术者对关节镜操作技术不熟练、医护配合不好、术中关节内结构显露不清，以及磨损老化的器械没有及时更换所致。只要注意改进上述环节，即可减少并发症及意外的发生。
Objective To analyse the causes of complications and accidents of arthroscopy and a discussion of the preventive measures. Methods 1 540 cases of arthroscopy were carried out from May 1980 to May 1999, including 1 426 cases of the knee, 59 of the ankle, 17 of the wrist, 21 of the first metatarsophalangeal joint, 8 of the hip, 6 of the elbow and 3 of the shoulder. Results Surgical instruments (blade, tip of forceps) broken in the articular cavity took place in 8 cases, injury of the normal tissue including the cartilage, meniscus, and ligaments happened in 40 cases, nerve branch and vascular injured around the inlets in 11 cases, water seeping out in 13 cases, infection following the formation of hematoma in 5 cases, refracture of patella during operation in 1 case, myocardial infarction after operation in 1 case, totally, complications and accidents were seen in 79 cases (5.1％ ). Conclusion Arthroscopic complications are mainly related to unskillful manipulation of the instruments, poor team work, inadequate exposure of intra-articular structure and negligence of timely replacing the nearly worn parts of the apparatus. The complications can all be prevented by improving above mentioned points.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2000年第9期552-554,共3页
Chinese Journal of Orthopaedics
关键词
关节镜
外科手术
手术中并发症
手术后并发症
Arthroscopy
Surgical procedures,endoscopic
Intraoperative complications
Postoperative complications
