关节镜清创术治疗膝骨性关节炎效果评价  

A DISCUSSION ABOUT ARTHROSCOPIC TREATMENT OF THE OSTEOARTHRITIC HNEE

作　　者：高春阳[1] 周斌[1] 李罡[1] 林波[1] 赵育松[2] 

机构地区：[1]牡丹江医学院附属红旗医院骨科,黑龙江牡丹江157011 [2]哈尔滨医科大学第二医院风湿科,黑龙江哈尔滨150000

出　　处：《牡丹江医学院学报》2007年第3期3-5,共3页Journal of Mudanjiang Medical University

基　　金：牡丹江医学院优秀青年科学基金项目(2002)

摘　　要：目的:探讨关节镜治疗膝骨性关节炎效果,为临床治疗决策提供参考。方法:对105例膝骨性关节炎患者行关节镜下清创术并进行超过1a的随访,记录临床表现、X线、关节镜资料,进行综合分析。效果评价由一个含有5个指标的评分系统进行,包括关节肿胀、关节压痛、蹲起痛、休息痛、关节磨擦音。疗效客观上从好到坏进行分级。结果:关节镜下所有病例存在不同程度滑膜炎,各级软骨退变共计91例(86%),半月板磨损19例(17%),游离体9例(8%)。关节镜清创术后1个月各项指标较术前均有显著改善(p<0.01)。1a后除蹲起痛与关节磨擦音两项差异无显著性外(p>0.05),其他三项有显著改善(p<0.01)。根据这一分析方法,有78例(74%)疗效满意,17例(18%)疗效一般,10例(8%)疗效不满意。其中4例疗效一般患者一年后逐渐恶化。结论:关节镜下清创术是诊断和治疗膝骨性关节炎良好方法。但目前尚不能判断症状改善能持续多久,需进一步探讨。Objective：To.investigate the effect of arthroscopic treating on the osteoarthritic knee so as to providt reference for clinical treatment. Methods： 105 OA patients who accepted arthroscopic treatment were followed up for 1 year or more. Reviews of general materials, clinical symptoms and sign, radiographs and arthroscopy were made respectively, followed -up contents included knee pain, positive crepitus, touch pain, squating pain and so on. All signs were Graded from excellent to bad and effects were evaluated. Results： of the OA patients, arthroscopy revealed synovium disease in all patients, articular cartilage degradati niscal degradation in 19cases（ 17% ）. After treated by arthroscopic on of different grade in 91cases（86% ）and meoperation , the five indications of patients were improved markedly in 1 month（ p 〈0.01 ）, and in 12 months conditions were also improve.d except squatting pain and crepitus （ p 〉0.05）. According to the analysis, it showed excellent in 78 cases（74% ）, good in 17 cases （18%）and bad in 10 cases（9% ）. In 12 months , 4 good cases turned to bad. Conclusion：arthroscopic treatment was effective on OA therapy, but how long the patients could persist？ Such question is worth further discussion.

关 键 词：关节镜 治疗 膝 骨性关节炎 效果 

分 类 号：R324[医药卫生—人体解剖和组织胚胎学]