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目的:探讨中药熏洗结合关节镜微创手术治疗膝关节术后关节内纤维粘连的方法和疗效。方法:治疗组17例膝关节粘连患者,年龄17~57岁,平均34.8岁。术前1周中药熏洗,关节镜下松解髌上囊、髁间窝及双侧隐窝的粘连,术后第2天CPM机开始功能锻炼,拆线1周后中药熏洗。结果:随访6个月~1年。疗效评定按Judet疗效评定法,优14例,良2例,可1例。平均较术前改善70.5°。无一例患者出现伤口感染和皮肤坏死等并发症。结论:中药熏洗结合关节镜微创手术治疗膝关节术后关节内纤维粘连具有创伤小、术后疼痛轻、并发症少、康复快,符合中医辨证等优点,是治疗膝关节粘连的有效方法。
Objective: To explore the method and effect of traditional Chinese medicine fumigation combined with minimally invasive arthroscopic treatment of intra-articular fibrosis after knee joint surgery. Methods: Seventeen patients with knee joint adhesions in the treatment group, aged from 17 to 57 years (average 34.8 years). One week before operation, fumigation of traditional Chinese medicine, arthroscopic release of the supracondylar patella, intercondylar fossa and bilateral recess adhesions, CPM machines after 2 days began functional exercise, stitches a week after the traditional Chinese medicine fumigation. Results: Followed up for 6 months to 1 year. Efficacy assessment by Judet efficacy evaluation method, excellent in 14 cases, good in 2 cases, in 1 case. The average improvement of 70.5 ° compared with preoperative. None of the patients had complications such as wound infection and skin necrosis. Conclusion: Fumigation with traditional Chinese medicine combined with minimally invasive arthroscopic treatment of intra-articular adhesions has the advantages of less trauma, less postoperative pain, fewer complications, quick recovery, in line with traditional Chinese medicine syndrome differentiation and other advantages, is an effective method of treatment of knee joint adhesions .