肌骨超声观察针刀治疗膝骨关节炎软组织变化  

Soft tissue changes observed through musculoskeletal ultrasound in the treatment of knee osteoarthritis with needle-knife

作　　者：张雷[1] 王庆甫[2] 殷岳杉[2] 郭盛君[2] 常青[2] 张岩峰[2] 王丽莎[2] 戚晴雪[1] 郑皓云 杨黎黎[1] 赵军[1] 马玉峰[1] 吴忌[1] 郎松[1] 

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学第三附属医院,北京100029

出　　处：《中国骨伤》2014年第1期17-20,共4页China Journal of Orthopaedics and Traumatology

基　　金：首都医学发展基金项目(编号:SF-2009-Ⅱ-08);北京中医药大学自主选题项目资助(编号:2010JYB22XS-019)~~

摘　　要：目的:通过肌骨超声(MSUS)观察针刀治疗膝关节骨性关节炎患者膝部软组织前后的变化,为针刀治疗膝关节骨性关节炎提供肌骨超声学依据。方法:病例来源于2011年12月至2012年12月在北京中医药大学第三附属医院门诊及住院部诊治的膝关节骨性关节炎患者,按照纳入、排除标准纳入受试者50例并给予针刀松解术1次。以治疗前1天和治疗后2周为前后对照,通过问卷调查方式来记录治疗前后痛疼(VAS)评分、膝关节周径;通过MSUS检查观察患膝关节腔积液量以及关节周围滑膜厚度的变化。结果:治疗前患者膝关节疼痛指数6.850±1.417,治疗后2.790±1.299,疗后低于疗前;治疗前患者膝关节周径(407.320±45.151)mm,治疗后(391.240±41.129)mm,疗后周径小于疗前。肌骨超声下观察关节积液量治疗后治愈47膝,好转19膝,无效2膝;滑膜厚度治疗后治愈43膝,好转17膝,无效8膝。结论:膝关节骨性关节炎患者膝关节积液量以及滑膜厚度在MSUS下的表现与患者主要症状、体征相一致,提示MSUS在观察针刀治疗KOA前后软组织变化上可信度较高。Objective： To study soft tissue changes observed through musculoskeletal ultrasound（MSUS） in the treatment of knee osteoarthritis with needle-knife,so as to provide MSUS basis for needle-knife in the treatment of knee osteoarthritis. Methods： Forty patients with knee osteoarthritis treated in the Third Affiliated Hospital of Beijing University of Chinese Medicine from December 2011 to December 2012 were selected according to inclusion and exclusion criteria. All the patients were treated with needle-knife release method. The VAS scores and knee joint circumference were recorded before treatment and 2 weeks after treatment. The changes of knee joint hydrops articuli and joint synovial thickness were measured through MSUS. Results： The knee pain index was 6.850±1.417 before treatment and 2.790±1.299 after treatment;the index after treatment was lower than that of before treatment. The knee joint circumference was 407.320±45.151 mm before treatment and 391.240±41.129 mm after treatment;the knee joint circumference decreased after treatment. The amount of hydrops articuli observed by musculoskeletal ultrasound showed that 47 knees were cured,19 knees improved and 2 knees failed. The synovial membrane thickness：43 knees cured,17 knees improved and 8 knees failed. Conclusion： The hydrops articuli and synovial thickness of knee joint of patients with knee osteoarthritis observed under the MSUS is consistent with the main symptoms and signs,which suggests that MSUS observation on soft tissue changes before and after needle knife in the treatment of knee osteoarthritis with high reliability.

关 键 词：超声检查 针刀 骨关节炎 膝 滑膜 

分 类 号：R684.3[医药卫生—骨科学]