不同方案治疗单纯髌内侧滑膜皱襞综合征的疗效差异*

摘要： 目的??对比及分析单纯髌内侧滑膜皱襞综合征在不同方案治疗下的疗效差异。方法?所取病例来自该院2011年1月－2015年1月诊断为单纯单侧髌内侧滑膜皱襞综合征的患者，共计147例。根据治疗方法不同，将其分成A、B、C组，每组49例；根据年龄差异，各组内又分为青年及中老年组。A组采用药物及物理治疗；B组则定期行关节腔内注射治疗；C组采用关节镜手术治疗。所有患者治疗前及随访时均采用膝关节Lysholm评分进行评估，并进行统计学分析。结果?所有患者均获得平均11个月（9～13个月）随访，无神经血管损伤及感染发生。治疗前，A、B、C 3组组间的Lysholm评分的差异无统计学意义（F =0.08，P =0.926）。治疗后，A、B、C 3组末次随访的组间的Lysholm评分差异具有统计学意义（F =15.48， P =0.001）。A、B、C 3组治疗后Lysholm评分比治疗前均有提高，差异具有统计学意义（tA = 3.43，tB = 6.74，tC = 7.99，均P =0.001）。在Lysholm评分变化幅度中，C组>B组>A组（F =66.43，tAB =5.97，tAC =11.52，tBC =5.55，均P =0.001），总体青年组大于总体中老年组（t =7.91，P =0.001），差异具有统计学意义。结论?在单纯髌内侧皱襞综合征的治疗中，手术治疗方案效果最好。在中老年患者治疗上，需要在治疗前充分沟通，告知其疗效不佳可能。
Abstract: Objective?To compare and analyze the curative effects of mediopatellar plica syndrome under different therapies.?Methods?147 patients with mediopatellar plica syndrome were enrolled in the study from January 2011 to January 2015 and divided into three groups refer to treatment: Group A, B and C. Each group was also divided in the youth group and the mid-age group. Different treatments were used in the three groups. Group A: drug therapy and physicotherapeutics; Group B: intraarticular injection regularly; Group C: arthroscopic surgical treatment. All patient conditions were assessed with Lysholm score.?Results?All patients received an average of 11 (9 ~ 13) months follow-up. No blood-vessel and nerve injured and infection occurred. Before receiving treatment, difference in Lysholm score of the three groups showed no statistical difference (F = 0.08, P = 0.926); after treatment, difference revealed significant difference (F = 15.48, P = 0.001). Compared with those before operation and after operation among the three groups, the Lysholm score was improved (tA = 3.43, tB = 6.74, tC = 7.99, P = 0.001). In the rangeability of Lysholm score, the Group C > B > A (F = 66.43, tAB = 5.97, tAC = 11.52, tBC = 5.55, P = 0.001); The general youth group > the general mid-age (t = 7.91, P = 0.001).?Conclusion?The best therapeutic method for mediopatellar plica syndrome is the arthroscopy. As for mid-age patients, it is necessary to inform them of possibility that prognosis is not well in preoperative planning.