综合疗法联合关节镜清理术治疗膝关节骨性关节炎的近期疗效  

Short-term efficacy of comprehensive treatment combined with arthroscopic debridement for knee osteoarthritis

作　　者：李洪年[1] 邵礼武 朱献忠[1] 

机构地区：[1]邳州市人民医院骨科,江苏221300

出　　处：《中国骨科临床与基础研究杂志》2014年第6期350-354,共5页Chinese Orthopaedic Journal of Clinical and Basic Research

摘　　要：目的探讨综合疗法联合关节镜清理术治疗膝关节骨性关节炎(KOA)的近期效果。方法选择2012年10月至2014年3月江苏省邳州市人民医院收治的50例KOA患者,随机分为观察组和对照组,每组各25例。对照组采用单纯关节镜清理术,观察组在对照组基础上实施综合疗法(痛点阻滞、关节腔注射玻璃酸钠+曲安奈德和推拿按摩)。比较术后3、6个月两组Lysholm膝关节功能评分和视觉模拟量表(VAS)评分,同时记录两组股四头肌、股二头肌肌力峰力矩(PT)。结果术后3、6个月观察组Lysholm评分以及股四头肌、股二头肌肌力PT高于对照组,VAS评分低于对照组,两组比较,差异均有统计学意义(P<0.05)。两组术后均无严重不良反应。结论与单纯关节镜清理术相比,联用综合疗法能够更好地改善患膝关节功能,缓解疼痛症状,提高股四头肌、股二头肌肌力,近期疗效更为理想。Objective To investigate short-term effects of comprehensive therapy combined with arthroscopic debridement for knee osteoarthritis（KOA）.Methods Fifty patients with KOA treated in Peoples＇ Hospital of Pizhou City from October 2012 to March 2014,were randomly divided into observation group（n=25） and control group（n = 25）.Patients in control group underwent arthroscopic debridement only,and the observation group was given comprehensive therapy（pain spot blockage,intra-articular injection of sodium hyaluronate ＋ triamcinolone acetonide,as well as massage） combined with arthroscopic debridement.At 3,6 months after the surgery,Lysholm knee function scores and visual analogue scale（VAS） scores were compared between two groups,peak torque（PT） of quadriceps and biceps femoris muscle were recorded at the same time.Results At 3,6 months after the operation,Lysholm scores and PT of quadriceps and biceps femoris muscle in observation group were higher than those in control group,while VAS scores were lower than those in control group,the differences between two groups had statistical significance（P〈0.05）.There was no serious adverse reaction in 2 groups after the surgery.Conclusion Compared with arthroscopic debridement only,combination with comprehensive treatment could obtain better short-term efficacy because it is able to improve the function of knee joint,relieve pain symptom,and enhance muscle strength of quadriceps and biceps femoris more significantly.

关 键 词：骨关节炎 膝 关节镜检查 清创术 综合疗法 神经传导阻滞 注射 病灶内 透明质酸 曲安奈德 按摩 疼痛测定 肌张力 峰力矩 

分 类 号：R687.4[医药卫生—骨科学]