近排腕骨切除术在手腕部手术中的应用效果(1)
[摘要]目的 探讨近排腕骨切除术在手腕部手术中的应用效果。方法 选取2015年1月～2017年12月江西省大余县人民医院收治的手腕部需手术治疗的98例患者作为研究对象，根据研究方法的不同分为对照组和观察组，每组各49例。对照组实施临床常规手术治疗，观察组实施近排腕骨切除术治疗，比较两组患者的临床恢复优良率、术后疼痛评分(VAS)、腕关节功能评分(Cooney)及双手握力。结果 两组患者临床恢复优良率、Cooney评分比较，差异无统计学意义(P>0.05);观察组的术后VAS评分低于对照组，差异有统计学意义(P<0.05);观察组的患侧握力高于对照组，差异有统计学意义(P<0.05)。结论 近排腕骨切除术后腕关节保留了一定的活动度，能有效地缓解患者的疼痛，能部分保留患者术后腕关节功能。
[关键词]近排腕骨切除术;腕关节功能;应用效果
[中图分类号] R687.4 [文献标识码] A [文章编号] 1674-4721(2019)2(a)-0121-03
[Abstract] Objective To explore the application effect of proximal row carpectomy in wrist surgery. Methods A total of 98 patients with wrist surgery in Dayu People′s Hospital of Jiangxi Province from January 2015 to December 2017 were selected as the research objects， according to the different research methods， they were divided into control group and observation group， with 49 cases in each group. The control group was treated with routine operation， while the observation group was treated with proximal row carpectomy， the clinical excellent and good rate， postoperative pain score (VAS)， wrist function score (Cooney) and hand grip strength were compared between the two groups. Results There were no significant differences in clinical recovery rate and Cooney score between the two groups (P>0.05). The VAS score of the observation group was lower than that of the control group， the difference was significant (P<0.05). The grip strength of the affected side in the observation group was higher than that in the control group， the difference was significant (P<0.05). Conclusion After proximal row carpectomy， wrist joint retains certain range of motion， which can effectively alleviate the pain of patients and partly preserve the wrist function of patients after operation.
[Key words] Proximal row carpectomy; Wrist joint function; Application effect
近排腕骨切除术(PRC)是将腕关节近端的舟骨、月骨和三角骨予以切除，远排腕骨中的头状骨近极与桡骨远端的月骨窝组成相对匹配新的腕关节[1]。该手术最早是由伦敦Guy′s医院的Stamn医生于1939年提出并采用，治疗陈旧性腕关节损伤和月骨缺血性坏死[2]。由于手术破坏了腕关节的正常解剖关系，患者术后的肌力减弱，头状骨与桡骨的月骨窝接触并不完全可靠，因此从第1例手术出现至今，争议较多[2]。近年来，关于其生物力学的基础研究逐渐增多。但关于PRC后腕关节功能的恢复，腕部解剖关系的改变是否会引起新的腕部损伤，临床报道少见。本研究通过PRC后患者腕关节活动度、手部握力及疼痛程度3个主要方面进行临床效果评定，探讨PRC后对腕关节功能的影响，为临床相关治疗提供方法与经验，现报道如下。
1資料与方法
1.1一般资料
选取2015年1月～2017年12月江西省大余县人民医院收治的手腕部需手术治疗的98例患者作为研究对象，根据研究方法的不同分为对照组和观察组，每组各49例。观察组中，男28例，女21例;年龄20～65岁，平均(39.4±11.8)岁;对照组中，男30例，女19例;年龄20～65岁，平均(40.1±12.1)岁;两组患者的性别、年龄等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。本研究经医院医学伦理委员会审核批准。, 百拇医药(吴渊 张志明 周油山 等)
[关键词]近排腕骨切除术;腕关节功能;应用效果
[中图分类号] R687.4 [文献标识码] A [文章编号] 1674-4721(2019)2(a)-0121-03
[Abstract] Objective To explore the application effect of proximal row carpectomy in wrist surgery. Methods A total of 98 patients with wrist surgery in Dayu People′s Hospital of Jiangxi Province from January 2015 to December 2017 were selected as the research objects， according to the different research methods， they were divided into control group and observation group， with 49 cases in each group. The control group was treated with routine operation， while the observation group was treated with proximal row carpectomy， the clinical excellent and good rate， postoperative pain score (VAS)， wrist function score (Cooney) and hand grip strength were compared between the two groups. Results There were no significant differences in clinical recovery rate and Cooney score between the two groups (P>0.05). The VAS score of the observation group was lower than that of the control group， the difference was significant (P<0.05). The grip strength of the affected side in the observation group was higher than that in the control group， the difference was significant (P<0.05). Conclusion After proximal row carpectomy， wrist joint retains certain range of motion， which can effectively alleviate the pain of patients and partly preserve the wrist function of patients after operation.
[Key words] Proximal row carpectomy; Wrist joint function; Application effect
近排腕骨切除术(PRC)是将腕关节近端的舟骨、月骨和三角骨予以切除，远排腕骨中的头状骨近极与桡骨远端的月骨窝组成相对匹配新的腕关节[1]。该手术最早是由伦敦Guy′s医院的Stamn医生于1939年提出并采用，治疗陈旧性腕关节损伤和月骨缺血性坏死[2]。由于手术破坏了腕关节的正常解剖关系，患者术后的肌力减弱，头状骨与桡骨的月骨窝接触并不完全可靠，因此从第1例手术出现至今，争议较多[2]。近年来，关于其生物力学的基础研究逐渐增多。但关于PRC后腕关节功能的恢复，腕部解剖关系的改变是否会引起新的腕部损伤，临床报道少见。本研究通过PRC后患者腕关节活动度、手部握力及疼痛程度3个主要方面进行临床效果评定，探讨PRC后对腕关节功能的影响，为临床相关治疗提供方法与经验，现报道如下。
1資料与方法
1.1一般资料
选取2015年1月～2017年12月江西省大余县人民医院收治的手腕部需手术治疗的98例患者作为研究对象，根据研究方法的不同分为对照组和观察组，每组各49例。观察组中，男28例，女21例;年龄20～65岁，平均(39.4±11.8)岁;对照组中，男30例，女19例;年龄20～65岁，平均(40.1±12.1)岁;两组患者的性别、年龄等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。本研究经医院医学伦理委员会审核批准。, 百拇医药(吴渊 张志明 周油山 等)