肌腱套管加透明质酸钠局部注射防止肌腱粘连的临床疗效观察

目的探讨肌腱套管保护法和局部注射透明质酸钠对防止肌腱粘连的临床疗效。方法100例肌腱断裂患者,随机分为实验组和对照组,每组各50例,应用Kessler法端端吻合肌腱,然后实验组行连续锁边加强缝合,采用自制肌腱套管将肌腱吻合断端与周围软组织隔开,术后沿肌腱套管局部注入透明质酸钠;对照组仅行常规肌腱吻合。结果87例获随访,平均8.1个月（3个月-1年）,其中实验组42例,对照组45例。TAM疗效评价：实验组优33例,良4例,一般3例,差2例;对照组优20例,良9例,一般6例,差10例。实验组TAM疗效评价优良率达88.1%,明显高于对照组的64.4%（P〈0.05）。结论肌腱套管加透明质酸钠局部注射对防止肌腱粘连有较好的临床疗效,值得临床推广。

The Prevention of Tendon Adhesion by Musculotendinous Cuffing Followed by Sodium Hyaluronate Injection

Objective To observe the therapeutic effect of musculotendinous cuffing and local injection of sodium hyaluronate. Methods 100 patients with tendon rupture were divided randomly into two groups with 50 for each. In the study group, the muscle tendon was sewed by Kessler＇s suture, then the self-made musculotendinous cuff was wrapped and sodium hyaluronate was injected in several days after operation. And in the control group, the muscle tendon was reconstructed as usual. Results 87 cases were followed up for 8.1 （3 12） months averagely, in whom 42 of the study group, and 45 of the control group. In the study group, the TAM evaluation was excellent of 33 cases, fine of 4 cases, fair of 3 cases and worse of 2 cases. And in the control group, there was 20 of excellent, 9 of fine,6 of fair and 10 of worse. The fineness rate of the study group was 88.1%, which was significantly higher than 64.4% of the control group （ P 〈 0.05 ）. Conclusion It has good therapeutic effect in preventing tendon adhesion with musculotendinous cuffing followed by sodium hyaluronate injection.