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目的探讨关节镜手术治疗后足骨样骨瘤的临床效果。方法选取2013年10月至2015年10月间临朐县人民医院收治的23例后足骨样骨瘤患者,均行关节镜手术,观察患者手术时间和术前、术后3d、术后1周、术后3个月、术后12个月及术后18个月的疼痛评分,并比较患者治疗前后的AOFAS踝后足评分。结果患者均顺利完成手术,手术时间为20~45(29.56±3.45)min,术后患者未出现明显的不适感,术前患者疼痛评分为(7.45±2.12)分,术后3d、术后1周、术后3个月、术后12个月和术后18个月患者的疼痛评分分别为(3.56±0.45)分、(0.65±0.27)分、(0.54±0.25)分、(0.53±0.20)分和(7.45±2.12)分,术后各时间点与术前比较,疼痛评分均降低,差异均有统计学意义(均P<0.05)。随访时间为4~22(14.5±0.4)个月,期间无患者出现伤口感染、肺部感染和肿瘤复发等。术前患者AOFAS踝-后足评分为(40.56±3.2)分,术后为(90.54±6.77),两组比较,差异有统计学意义(P<0.05)。结论关节镜手术治疗足骨样骨瘤的近期效果较好,对周围组织损伤较小,安全性高,患者耐受性较好。
Objective To investigate the clinical effect of arthroscopic treatment of the osteoid osteoma. Methods Twenty-three patients with posterior hindfoot osteoma that were treated in Linqu County People’s Hospital from October 2013 to October 2015 were enrolled in this study. All the patients underwent arthroscopic surgery. The operative time, preoperative and postoperative 3d, , 3 months postoperatively, 12 months postoperatively and 18 months postoperatively. The AOFAS ankle and hindfoot scores of patients before and after treatment were compared. Results All patients underwent surgery successfully. The operative time was 20-45 (29.56 ± 3.45) min. There was no significant discomfort in the patients after operation. The score of pain before operation was (7.45 ± 2.12), 3d after operation and 1 (3.56 ± 0.45), (0.65 ± 0.27), (0.54 ± 0.25), (0.53 ± 0.20), (0.53 ± 0.20), and ) And (7.45 ± 2.12) points respectively. The scores of pain decreased at all time points after operation compared with that before operation. The difference was statistically significant (all P <0.05). The follow-up time ranged from 4 to 22 (14.5 ± 0.4) months, with no wound infection, lung infection and tumor recurrence. The AOFAS ankle - hind foot score was (40.56 ± 3.2) points before operation and (90.54 ± 6.77) days after operation. There was significant difference between the two groups (P <0.05). Conclusion Arthroscopic surgery for the treatment of osteosarcoma osteosarcoma better recent results, less damage to the surrounding tissue, high safety, patient tolerance is better.