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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:

第26卷

期數(shù):

2014年11期

頁碼:

15-16

欄目:

臨床研究

出版日期:

2014-11-30

文章信息/Info

Title:

The improved Kessler suture procedure for finger flexor tendon rupture in zoneⅡ

作者:

王眾; 李驥; 廖騰; 吳亞樂

中國人民解放軍第98醫(yī)院,浙江 湖州 313000

Author(s):

Wang Zhong^*; Li Ji; Liao Teng; Wu Yale.^*

The 98th hospital of PLA,Huzhou 313000,Zhejiang,China

關(guān)鍵詞:

手損傷 軟組織損傷 傷口縫合技術(shù)

Keywords:

Hand injuries;  Soft tissue injuries;  Wound closure techniques

摘要:

目的:觀察改良Kessler縫合法治療Ⅱ區(qū)指屈肌腱斷裂的臨床療效和安全性。方法:Ⅱ區(qū)指屈肌腱斷裂患者78例,隨機分為2 組,每組39例,分別采用改良Kessler縫合法和常規(guī)縫合法縫合斷裂肌腱。術(shù)后觀察2組患者肌腱愈合、患指功能恢復(fù)及并發(fā)癥發(fā) 生情況,并對2組的療效和并發(fā)癥發(fā)生率進行比較。結(jié)果:78例均獲隨訪,隨訪時間3～6個月,依據(jù)中華醫(yī)學(xué)會手外科學(xué)分會手部肌 腱修復(fù)后評定標準評價療效,改良Kessler縫合組,優(yōu)25例、良11例、可2例、差1例; 常規(guī)縫合組,優(yōu)15例、良12例、可8例、差4 例。改良Kessler縫合組療效優(yōu)于常規(guī)縫合組(Z=-2.654,P=0.008)。改良Kessler縫合組創(chuàng)面均一期愈合。常規(guī)縫合組,術(shù)后并發(fā) 淺表感染2例,經(jīng)換藥愈合; 并發(fā)深度感染1例,經(jīng)拆除縫線、行負壓封閉引流后愈合; 并發(fā)肌腱再斷裂2例,改行改良Kessler縫合 后愈合。2組間并發(fā)癥發(fā)生率比較,改良Kessler縫合組小于常規(guī)縫合組(P=0.027)。結(jié)論:改良Kessler縫合法治療Ⅱ區(qū)指屈肌腱 斷裂,有利于肌腱愈合和患指功能恢復(fù),并發(fā)癥少,療效優(yōu)于常規(guī)縫合法。

Abstract:

Objective:To observe the clinical curative effects and safety of improved Kessler suture procedure in the treatment of finger flexor tendon rupture in zoneⅡ.Methods:Seventy-eight patients with finger flexor tendon rupture in zoneⅡwere randomly divided into 2 groups,39 case in each group.The patients in the 2 groups were treated with improved Kessler suture procedure and conventional suture procedure respectively for the ruptured tendon.Tendon healing,finger function recovery and complication were observed,and the curative effect and complication incidence were compared between the 2 groups.Results:All patients in the 2 groups were followed up for 3-6 months with a median of 4 months.According to the evaluation criteria for hand tendon repair issued by Hand Surgery Branch of Chinese Medical Association,25 patients obtained an excellent result,11 good,2 fair and 1 poor in the improved group,while 15 patients obtained an excellent result,12 good,8 fair and 4 poor in the conventional group.The curative effect was better in the improved group compared to the conventional group(Z=-2.654,P=0.008).The patients got primary healing in the operative incisions in improved group,while super incisions infection(2),deep incisions infection(1)and tendon re-breakage(1)were found in the conventional group.The complication rates were lower in the improved group compared to the conventional group (P=0.027).Conclusion:In the treatment of finger flexor tendon rupture in zoneⅡ,the improved Kessler suture procedure is conducive to tendon healing and finger functional recovery with few complications,and its curative effect is better than conventional suture procedure.

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更新日期/Last Update: 2014-11-30