摘要
目的探讨终末期踝关节融合术后患者疼痛功能及生活质量的改善效果。方法2013年3月—2017年3月于北京大学深圳医院运动医学科接受踝关节融合手术并规律随访超过2年的患者共19例,其中男性10例,女性9例,平均年龄(54.7±7.8)岁;按照病因分类:踝关节炎8例、创伤性关节炎7例、距骨坏死4例。使用视觉模拟评分法(visual analogue score,VAS)、36条简明健康状况调查表(short form 36-item health survey,SF-36)及美国足踝外科学会(American Orthopedic Foot and Ankle Society,AOFAS)踝-后足评分对上述患者在术后0.5年、1年、2年进行随访评估。结果19例患者术后踝关节均融合,其中后路伤口坏死1例,融合位置不良(轻度跖屈)1例,随访期邻近关节退变2例。术后0.5年较术前VAS评分、AOFAS评分、SF-36评分均得到显著改善(P=0.000);术后1年较术后0.5年的VAS评分有显著改善(P=0.000),AOFAS评分(P=0.011)、SF-36评分(P=0.002)的改善差异有统计学意义,而术后2年较术后1年的VAS评分(P=0.262)、AOFAS评分(P=0.148)、SF-36评分(P=0.216)保持相对稳定,差异无统计学意义。结论对于终末期踝关节炎患者,踝关节融合术可缓解疼痛,改善活动耐量,提高生活质量,并且该疗效可至少维持至中期。
Objective To investigate the clinical effect on the improvement of pain,function and quality of life in patients after ankle arthrodesis.Methods A total of 19 patients who underwent ankle fusion surgery in the Peking University Shenzhen Hospital from March 2013 to March 2017 were regularly followed up for more than 2 years,including 10 males and 9 females,with an average age of(54.7±7.8)years old.Classification according to the cause:8 cases of Ankle osteoarthritis,7 cases of traumatic arthritis,and 4 cases of talus necrosis.The above patients were followed up with visual analogue score(VAS),short form 36-item health survey(SF-36)and American Orthopedic Foot and Ankle Society(AOFAS)ankle-hind foot score,for 0.5 year,1 year,and 2 years after surgery.Results The ankle joints were fused in 19 patients,including 1 case with posterior wound necrosis,1 case with malaligment fusion position(mild plantar flexion),and 2 cases with adjoining joint degeneration during the follow-up period.VAS score,AOFAS score,and SF-36 score at 0.5 year after surgery were significantly improved compared with presurgery(P=0.000).VAS scores at 1 year after surgery were significantly improved(P<0.000),and AOFAS scores(P=0.011)and SF-36 scores(P=0.002)were statistically improved compared with 6 months after surgery,respectively.While the VAS score(P=0.262),AOFAS score(P=0.148),and SF-36 score(P=0.216)at 2 years after surgery remained relatively stable compared with 1 year after surgery.Conclusion Ankle arthrodesis could relieve pain,improve exercise tolerance,improve quality of life for patients with end stage ankle arthritis,and the effect could be maintained at least to the mid-term.
作者
蒋官玮
唐陆波
刘三彪
白露
张文涛
张新涛
Jiang Guanwei;Tang Lubo;Liu Sanbiao;Bai Lu;Zhang Wentao;Zhang Xintao(Clinical institute,Peking University Shenzhen Hospital,Anhui Medical University,Shenzhen 518063,China;Department of sports medicine,Peking University Shenzhen Hospital,Shenzhen 518036,China)
出处
《足踝外科电子杂志》
2021年第2期30-34,共5页
Electronic Journal of Foot and Ankle Surgery
基金
深圳市卫计委三名工程学科能力提升项目(SZXJ2018085)。
