程序化麻醉下手法松解术治疗膝关节创伤术后关节粘连的21例临床报告

doi:10.3969/j.issn.1674-8115.2021.04.010

上海交通大学学报(医学版) ›› 2021, Vol. 41 ›› Issue (4): 479-482.doi: 10.3969/j.issn.1674-8115.2021.04.010

程序化麻醉下手法松解术治疗膝关节创伤术后关节粘连的21例临床报告

姜鑫¹^,²(), 贺英¹(), 蔡斌¹^,², 范帅¹^,², 李晓燕¹, 康志斌¹

^1.上海市奉贤区奉城医院康复医学科，上海 201411
^2.上海交通大学医学院附属第九人民医院康复医学科，上海 200011

收稿日期:2020-05-18 出版日期:2021-04-28 发布日期:2021-05-14
通讯作者: 贺英 E-mail:jiangxinkylie@163.com;18918265660@189.com
作者简介:姜鑫（1984—），女，主管技师，学士；电子信箱：jiangxinkylie@163.com。
基金资助:
国家重点研发计划(2018YFF0300504);上海市奉贤区临床诊疗中心建设计划(fxlczlzx-a-201706);上海市奉贤区社会类科技发展基金(20181901)

Procedural manipulation under anesthesia for joint adhesion after trauma of knee operation: report of 21 cases

Xin JIANG¹^,²(), Ying HE¹(), Bin CAI¹^,², Shuai FAN¹^,², Xiao-yan LI¹, Zhi-bin KANG¹

^1.Department of Rehabilitation Medicine, Fengcheng Hospital of Fengxian District, Shanghai 201411, China
^2.Department of Rehabilitation Medicine, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China

Received:2020-05-18 Online:2021-04-28 Published:2021-05-14
Contact: Ying HE E-mail:jiangxinkylie@163.com;18918265660@189.com
Supported by:
National Key R&D Program of China(2018YFF0300504);Construction Plan of Clinical Diagnosis and Treatment Center of Fengxian District in Shanghai(fxlczlzx-a-201706);Shanghai Fengxian District Social Science and Technology Development Fund(20181901)

摘要/Abstract

摘要：

目的·探讨使用程序化麻醉下手法松解术（manipulation under anesthesia，MUA）治疗膝关节创伤术后关节粘连的临床疗效及安全性。方法·入选21例膝关节创伤术后关节粘连患者（包括膝关节多韧带损伤重建和/或修补术后6例、膝关节周围骨折内固定术后9例、髌骨脱位术后6例），行程序化MUA。使用关节量角尺评估患者在程序化MUA前、中、后随访（2周、12周、24周）的屈膝角度；使用视觉模拟评分法（visual analogue scale，VAS）评估患者在程序化MUA后2周内的疼痛程度；记录患者于程序化MUA中、后可能出现的并发症。结果·程序化MUA前、中、后随访（2周、12周、24周），患者的平均屈膝角度分别为73.8°、119.3°、101.7°、122.5°、127.4°。与术前相比，程序化MUA后24周的平均屈膝角度增加了53.6°。VAS评估结果显示，患者仅在术后1~3 d活动状态下的评分超过4分。术中及术后均未有并发症发生。结论·程序化MUA治疗膝关节创伤后关节粘连相对安全且有效。

关键词: 关节粘连, 膝关节创伤, 麻醉下手法松解术

Abstract:

Objective· To investigate the clinical efficacy and safety of procedural manipulation under anesthesia (MUA) for joint adhesion after trauma of knee operation.

Methods· Twenty one patients with joint adhesion after trauma of knee operation (including 6 cases after reconstruction and/or repair of multiple ligament injury of knee joint, 9 cases after internal fixation of fracture around the knee joint, and 6 cases after operation of patellar dislocation) were treated with procedural MUA. The knee flexion angle was evaluated before, during and after procedural MUA (2, 12 and 24 weeks) with joint protractor. The pain degree was evaluated by visual analogue scale (VAS) within 2 weeks after procedural MUA. The possible complications were recorded during and after procedural MUA.

Results·Before, during and after procedural MUA (2, 12 and 24 weeks), the average knee flexion angle was 73.8°, 119.3°, 101.7°, 122.5° and 127.4°. Compared with preoperative, the average knee flexion angle increased 53.6° after procedural MUA (24 weeks). VAS evaluation results showed that the VAS score of patients in active state was more than 4 points only 1?3 days after operation. No complications occurred during and after the operation.

Conclusion· Procedural MUA is relatively safe and effective in the treatment of joint adhesion after trauma of knee operation.

Key words: joint adhesion, trauma of knee, manipulation under anesthesia (MUA)

中图分类号:

R493

姜鑫, 贺英, 蔡斌, 范帅, 李晓燕, 康志斌. 程序化麻醉下手法松解术治疗膝关节创伤术后关节粘连的21例临床报告[J]. 上海交通大学学报(医学版), 2021, 41(4): 479-482.

Xin JIANG, Ying HE, Bin CAI, Shuai FAN, Xiao-yan LI, Zhi-bin KANG. Procedural manipulation under anesthesia for joint adhesion after trauma of knee operation: report of 21 cases[J]. JOURNAL OF SHANGHAI JIAOTONG UNIVERSITY (MEDICAL SCIENCE), 2021, 41(4): 479-482.

图/表 2

表 1 姆瓦前、中、后患者的平均屈膝角度

Tab 1 Average knee flexion angle of patients before， during and after procedural MUA

Item	Before procedural MUA	During procedural MUA	After procedural MUA
Item	Before procedural MUA	During procedural MUA	2 d	2 weeks	12 weeks	24 weeks
Average knee flexion angle	73.8°±14.4°	119.3°±5.3°^①	90.8°±5.8°^①②	101.7°±9.1°^①②	122.5°±11.9°^①	127.4°±11.6°^①

图1 姆瓦后2周内患者在安静状态、活动状态下的疼痛评分均值

Fig 1 Average of pain score of patients in quiet state and active state during 2 weeks after procedural MUA

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程序化麻醉下手法松解术治疗膝关节创伤术后关节粘连的21例临床报告

Procedural manipulation under anesthesia for joint adhesion after trauma of knee operation: report of 21 cases

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