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目的探讨关节镜在四肢皮下或肌间血管瘤切除术中应用的临床价值。方法 2011年1月~2013年4月,48例四肢皮下或肌间血管瘤患者,根据术者不同分为2组各24例,关节镜组应用关节镜在皮下层或肌层分离形成腔隙,用刨削刀将血管瘤切除,并用射频刀止血。开放组采用传统开放切开术式。比较2组的手术时间、出血量,术后随访手术瘢痕长度、术区疼痛麻木不适感、外观满意度及复发、感染。结果 2组手术时间差异无显著性(P>0.05)。与开放组比较,关节镜组出血少[(1.0±0.6)ml vs.(12.1±5.9)ml,t=-9.156,P=0.000],切口瘢痕短[(0.60±0.16)cm vs.(10.20±5.42)cm,t=-8.653,P=0.000],疼痛麻木不适感轻(1.1±0.8 vs.2.1±1.0,t=-3.934,P=0.000),美观满意度高(8.4±1.3vs.5.3±1.5,t=7.505,P=0.000)。术后随访2~24个月,平均13个月,无复发、感染。结论关节镜在皮下或肌间血管瘤切除中安全可行,手术创面小,美观满意度高,达到了微创治疗与美容的效果。
Objective To investigate the clinical value of arthroscopy in resection of subcutaneous or intramuscular hemangiomas. Methods From January 2011 to April 2013, 48 patients with subcutaneous or intramuscular hemangiomas of limbs were divided into 2 groups of 24 patients according to the type of operation. The arthroscopy group was divided into sub-layers or muscular layers by arthroscopy , Cut with a planing hemangioma, and use a radio frequency knife to stop bleeding. Open group using the traditional open surgery. The operation time, the amount of bleeding, the length of the surgical scar, the numbness discomfort in the operation area, the appearance satisfaction and relapse and infection were compared between the two groups. Results There was no significant difference in operative time between the two groups (P> 0.05). Compared with the open group, arthroscopy had less bleeding [(1.0 ± 0.6) ml vs. (12.1 ± 5.9) ml, t = -9.156, P = 0.000) ± 5.42) cm, t = -8.653, P = 0.000]. The pain numbness was mild (1.1 ± 0.8 vs.2.1 ± 1.0, t = -3.934, P = 0.000) 5.3 ± 1.5, t = 7.505, P = 0.000). The patients were followed up for 2 to 24 months with an average of 13 months without recurrence and infection. Conclusions Arthroscopy is safe and feasible in resection of subcutaneous or intramuscular hemangiomas. It has a small operative wound and high aesthetic satisfaction. It achieves the effect of minimally invasive treatment and cosmetic treatment.