膝关节镜下活瓣扩大切除联合囊壁切除术对腘窝囊肿患者疼痛及囊肿残存情况的影响

Effects of knee arthroscopic enlarged valve resection combined with cyst wall resection on pain and residual cyst in patients with popliteal cyst

摘要:

目的 观察膝关节镜下活瓣扩大切除（AEVR）联合囊壁切除术（CWR）治疗腘窝囊肿的效果。方法 回顾性分析2022年6月－2023年6月该院收治的80例腘窝囊肿患者的临床资料，根据术式不同分为两组，A组（39例）行传统开放囊肿切除术（TOC），B组（41例）行AEVR-CWR。比较两组患者围手术期指标、住院时间、疼痛情况、膝关节功能、膝关节活动范围、腘窝囊肿分级、术后并发症和囊肿残存情况。结果 B组术中出血量明显少于A组，术后并发症总发生率和术后6个月时囊肿残存率明显低于A组，切口长度和住院时间明显短于A组，手术时间明显长于A组，差异均有统计学意义（P < 0.05）；两组患者术后视觉模拟评分法（VAS）评分明显低于术前，且B组明显低于A组，差异均有统计学意义（P < 0.05）；两组患者术后Lysholm评分明显高于术前，且B组明显高于A组，膝关节活动范围明显大于术前，且B组明显大于A组，差异均有统计学意义（P < 0.05）；两组患者术后Rauschning-Lindgren分级较术前明显改善，且B组优于A组，差异均有统计学意义（P < 0.05）。结论 AEVR-CWR可减少腘窝囊肿手术出血量，缩短切口长度和住院时间，减轻患者疼痛，扩大膝关节活动范围，改善膝关节功能和腘窝囊肿分级，降低术后并发症总发生率和术后6个月时囊肿残存率，但手术时间会延长。

Abstract:

Objective To observe the effect of knee arthroscopic enlarged valve resection (AEVR) combined with cyst wall resection (CWR) on popliteal cyst.Methods A retrospective analysis was conducted on the clinical data of 80 patients with popliteal cyst from June 2022 to June 2023. They were divided into two groups based on different surgical methods. Group A received 39 cases of traditional open cystectomy (TOC), while group B received 41 cases of AEVR-CWR. The perioperative indicators, length of hospital stay, pain status, knee joint function, knee joint range of motion, popliteal cyst grading, postoperative complications, and cyst survival were compared between the two groups.Results The surgical bleeding volume, total incidence of postoperative complications, and residual cyst rate at 6 months after surgery in group B were lower than those in group A, the incision length, and hospital stay in group B were shorter than those in group A, surgery time in group B was longer than that in group A, the differences were statistically significant (P < 0.05). After surgery, the visual analogue scale (VAS) of both groups was lower than that before surgery, and group B was lower than group A, the difference was statistically significant (P < 0.05). After surgery, the Lysholm score of both groups were higher than that before surgery, and group B was higher than group A, the knee range of motion of both groups were greater than that before surgery, and group B was greater than group A, the differences were statistically significant (P < 0.05). After surgery, the Rauschning-Lindgren grading of both groups was better than that before surgery, and group B was better than group A, the difference was statistically significant (P < 0.05).Conclusion The combination of AEVR and CWR can reduce surgical bleeding, shorten incision length and hospital stay, alleviate pain, improve knee joint range of motion, knee joint function, and grading of popliteal cysts, reduce the total incidence of postoperative complications and the residual rate of cysts at 6 months after surgery, but the surgery time has been extended.