[1]林红明,孙斌,吕和,等.关节镜下清理联合网状缝合治疗下肢巨大皮下血肿的临床研究[J].中医正骨,2022,34(08):20-24.
 LIN Hongming,SUN Bin,LYU He,et al.A clinical study of arthroscopic debridement combined with meshed suture for treatment of giant subcutaneous hematoma in lower limbs[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(08):20-24.
点击复制

关节镜下清理联合网状缝合治疗下肢巨大皮下血肿的临床研究()
分享到:

《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期数:
2022年08期
页码:
20-24
栏目:
临床研究
出版日期:
2022-08-20

文章信息/Info

Title:
A clinical study of arthroscopic debridement combined with meshed suture for treatment of giant subcutaneous hematoma in lower limbs
作者:
林红明孙斌吕和邬艳瑛吴旭东
(舟山市中医院,浙江 舟山 316000)
Author(s):
LIN HongmingSUN BinLYU HeWU YanyingWU Xudong
Zhoushan City Hospital of Traditional Chinese Medicine,Zhoushan 316000,Zhejiang,China
关键词:
血肿 下肢 关节镜检查 缝合技术 临床试验
Keywords:
hematoma lower extremity arthroscopy suture techniques clinical trial
摘要:
目的:观察关节镜下清理联合网状缝合治疗下肢巨大皮下血肿的临床疗效和安全性。方法:将36例符合要求的下肢巨大皮下血肿患者随机分为2组。关节镜手术组17例,采用关节镜下清理联合网状缝合治疗; 开放手术组19例,采用常规切开清理联合网状缝合治疗。比较2组患者的手术时间、出血量、创口愈合时间、术后疼痛视觉模拟量表(visual analogue scale,VAS)评分及并发症发生情况。结果:2组患者均顺利完成手术,均未发生血管、神经损伤等并发症。所有患者均获随访,随访时间6~8个月,中位数7个月。术后所有患者的血肿均清除,皮肤切口和深层组织愈合良好。关节镜手术组在手术时间、出血量、创口愈合时间及术后6个月疼痛VAS评分方面均优于开放手术组[(31.76±4.32)min,(61.84±6.06)min,P=-16.959,P=0.000;(19.41±4.64)mL,(53.16±7.30)mL,P=-16.318,P=0.000;(13.18±0.95)d,(16.11±1.66)d,P=-6.381,P=0.000;(0.18±0.39)分,(1.11±0.94)分,P=-3.796,P=0.001]。结论:关节镜下清理联合网状缝合可有效治疗下肢巨大皮下血肿,安全性较高; 与常规切开清理联合网状缝合治疗相比,具有创伤小、手术时间短、创口愈合快的优势。
Abstract:
Objective:To observe the clinical outcomes and safety of arthroscopic debridement combined with meshed suture for treatment of giant subcutaneous hematoma in lower limbs.Methods:Thirty-six patients with giant subcutaneous hematoma in lower limbs were enrolled in the study and were randomly divided into arthroscopic surgery group(17 cases)and open surgery group(19 cases).The patients in arthroscopic surgery group were treated with arthroscopic debridement and meshed suture,while the ones in open surgery group with conventional open debridement and meshed suture.The operative time,blood loss,incision healing time,postoperative pain visual analogue scale(VAS)score and complications were compared between the 2 groups.Results:The surgery was finished successfully in all patients,and no complications such as blood vessel injuries and nerve injuries were found in the 2 groups.All patients were followed up for 6-8 months with a median of 7 months.The hematoma was cleared in all patients,and the skin incision and deep tissues healed well.The arthroscopic surgery group surpassed open surgery group in operative time,blood loss,incision healing time and pain VAS score evaluated at postoperative month 6(31.76±4.32 vs 61.84±6.06 minutes,P=-16.959,P=0.000; 19.41±4.64 vs 53.16±7.30 mL,P=-16.318,P=0.000; 13.18±0.95 vs 16.11±1.66 days,P=-6.381,P=0.000; 0.18±0.39 vs 1.11±0.94 points,P=-3.796,P=0.001).Conclusion:Arthroscopic debridement combined with meshed suture can effectively treat giant subcutaneous hematoma in lower limbs with high safety,and it displays the advantages of less trauma,shorter operative time and faster incision healing compared to conventional open debridement and meshed suture.

参考文献/References:

[1] 何黎,赵蕊,黄相.床旁超声在外伤性肌肉血肿急诊处理中的应用[J].右江民族医学院学报,2015,37(1):99-103.
[2] 王津惠,彭立红,孔芳,等.弹性绷带加压包扎在颌面创伤美容整形治疗中的应用[J].中华灾害救援医学,2019,7(2):101-102.
[3] 林忠勤,谢海风,骆国钢,等.关节镜清除联合拉花式深部缝合治疗皮下血肿36例[J].中国中医骨伤科杂志,2021,29(3):62-66.
[4] ZHANG H,LI Q.Improved vacuum sealing drainage for treatment of surgical site infection following posterior spinal internal fixation:a case report[J].Medicine(Baltimore),2018,97(7):e9952.
[5] 高明刚,刘洪江.VSD治疗外伤性巨大皮下血肿的临床体会[J].中国农村卫生,2017(2):29-30.
[6] 朱燕飞,章英良,侯桥,等.负压封闭引流技术治疗下肢创伤性皮下血肿的疗效观察[J].现代实用医学,2020,32(6):708-709.
[7] 李文惠,柳国斌.腓肠肌血肿误诊为下肢深静脉血栓形成[J].临床误诊误治,2016,29(7):49-50.
[8] HEFNY A F,KAKA L N,SALIM N A,et al.Unusual case of life threatening subcutaneous hemorrhage in a blunt trauma patient[J].Int J Surg Case Rep,2015,15:119-122.
[9] SCOLARO J A,CHAO T,ZAMORANO D P.The morel-lavallée lesion:diagnosis and management[J].J Am Acad Orthop Surg,2016,24(10):667-672.
[10] 王伯珉,吕小龙.软组织损伤的临床治疗[J].创伤外科杂志,2020,22(9):718-721.
[11] 李翔.下肢软组织损伤的评估及治疗[J].创伤外科杂志,2020,22(9):641-645.
[12] 黄韧.早期外伤性闭合性小腿较大皮下血肿行切开引流术的效果观察[J].中外医学研究,2019,17(32):41-43.
[13] 金一,丑克,余敏.关节镜微创技术在关节外手术的应用与疗效观察[J].中国社区医师,2020,36(10):55.
[14] 邓伟.关节镜技术在关节外领域的应用研究进展[J].现代医药卫生,2019,35(14):2160-2162.
[15] 李海滨,王铭,杨学桥,等.血肿内麻醉关节镜下清理纱包固定治疗四肢皮下血肿[J].实用骨科杂志,2020,26(1):86-88.
[16] 杜生富,姜明霞,赵刚.关节镜下清创联合贯穿缝合治疗皮下血肿23例[J].中国矫形外科杂志,2012,20(21):1993-1994.
[17] 朱迎春,贾学文,王哲洋,等.关节镜手术治疗坐骨结节囊肿前瞻性病例对照研究[J].中国骨伤,2018,31(3):217-221.
[18] 李焱,李殿威,杨明宇,等.关节镜联合内镜技术经上关节囊入路治疗肩关节盂盂上切迹囊肿二例[J].中国修复重建外科杂志,2021,35(3):401-402.
[19] 袁伶俐,徐文弟,韩冠生,等.全关节镜下与传统手术方法治疗腘窝囊肿疗效比较[J].中国骨伤,2019,32(2):151-155.
[20] 刘振斌,王刚,李梦虎.下肢深静脉血栓形成的中西医治疗进展[J].中国中西医结合外科杂志,2021,27(1):149-153.
(收稿日期:2021-09-26 本文编辑:李晓乐)

相似文献/References:

[1]饶 俐.彩色多普勒超声检查在下肢深静脉血栓诊断中的价值[J].中医正骨,2015,27(06):23.
[2]张永兴,王磊,董钊,等.颈椎后路单开门减压术后并发硬膜外血肿2例[J].中医正骨,2011,23(12):73.
[3]章峰火,张文亚,胡玉祥,等.急诊利用反取皮回植联合负压封闭引流技术治疗 下肢大面积皮肤撕脱伤[J].中医正骨,2016,28(02):59.
[4]宋卿鹏,田伟,何达,等.超声及电刺激引导下神经根封闭治疗腰椎退行性疾病导致的下肢放射痛[J].中医正骨,2018,30(06):44.
[5]周黎,郭涛.自发性硬脊膜外血肿8例诊治分析[J].中医正骨,2019,31(08):70.
[6]张磊,王新卫,陈雨声,等.应用牵拉再生技术治疗下肢复杂软组织缺损[J].中医正骨,2021,33(07):53.
 ZHANG Lei,WANG Xinwei,CHEN Yusheng,et al.Application of distraction histogenesis technique for treatment of complex soft tissue defects of lower extremities[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(08):53.

备注/Memo

备注/Memo:
通讯作者:吴旭东 E-mail:wxd220@163.com
更新日期/Last Update: 1900-01-01