透明质酸钠联合膝关节镜下关节清理治疗髌股关节炎膝前痛的临床价值  

Clinical values of sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients

作　　者：刘堂鑫[1] 姚忠军[1] 何明武[1] 田彩霞[2] 

机构地区：[1]湖北省十堰市太和医院湖北医药学院附属医院骨科,442000 [2]湖北医药学院附属人民医院

出　　处：《中国综合临床》2016年第2期153-156,共4页Clinical Medicine of China

摘　　要：目的探讨透明质酸钠联合膝关节镜下关节清理治疗髌股关节炎膝前痛的临床价值。方法选择2012年6月至2015年9月湖北医药学院附属太和医院诊治的髌股关节炎膝前痛患者136例，根据随机数字表法分为治疗组与对照组各68例，所有患者都给予膝关节镜下清理术治疗，对照组术后口服硫酸氨基葡萄糖胶囊，治疗组术后选择关节腔内注射透明质酸钠治疗，治疗周期为5周。结果术后5周治疗有效率：对照组和治疗组分别为89．7％（61／68）、98．5％（67／68），治疗组效果更好（χ^2=4．202，P〈O．05）。疼痛评分：治疗组和对照组分别为（1．34±0．45）分和（2．89±0．62）分，均明显低于术前的（7．30±0.76）分和（7．31±0．56）分（t值分别为34．855、25．142，P均〈0.05）。Lysholm评分：治疗组和对照组分别为（88．87±6．33）分和（76．13±5．98）分，均明显高于术前的（44．23±4．29）分和（44．67±5．13）分（t值分别为14．875、8．113，P均〈0．05）。对照组和治疗组不良反应的发生率分别为13．2％（6／68）、8．8％（9／68），组间比较差异无统计学意义（χ^2=0．391，P〉0．05），所有不良反应经过对症处理后好转。结论透明质酸钠联合膝关节镜下关节清理治疗髌股关节炎膝前痛能有效发挥镇痛与促进膝关节功能改善的作用，有效、安全，值得推广应用。Objective To investigate the clinical values of sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients. Methods From June 2012 to September 2015 in Taihe Hospital Affiliated to Hubei Medical College, 136 patellofemoral arthritis knee pain patients were selected and randomly divided into treatment group （ 68 cases） and control group （ 68 cases）. All patients were given arthroscopic joint clean-up surgery, the control group were given the postoperative glucosamine sulfate capsules treatment, and the treatment group were given the postoperative intra-articular injection of sodium hyaluronate choose treatment, the treatment period was 5 weeks. Results Five weeks after treatment, the response rates in the treatment group and control group were 98.5% （67/68） and 89. 7% （61/68）, and the effect of the treatment group was better（χ^2=4. 202, P〈0.05） . The pain scores in the treatment and control group were （ 1.34±0. 45） points and （2. 89±0. 62） points, significantly lower than that of before operation （ （ 7.30±0.76 ） points and （ 7.31±0.56 ） points; t = 34. 855, 25. 142; P 〈 0.05 ） . The Lysholm score in the treatment and control group were （ 88.87±6. 33 ） points and （ 76. 13± 5.98 ） point, significantly higher than before operation （ （ 44. 23±4.29 ） points and （ 44.67±5.13 ） point; t = 14. 875, 8. 113 ;P〈0. 05） . The incidence of adverse events during the treatment in the treatment group and the control group were 8. 8% （6/68） and 13. 2% （9/68） respectively, there was no significant differernee between the two groups （χ^2= 0. 391,P〉0. 05） . All adverse reactions after symptomatic treatment were improved. Conclusion Sodium hyaluronate combined arthroscopic joint clean-up surgery for the patellofemoral arthritis knee pain patients can effectively play the role of promoting the knee pain and function, and has good efficacy and safety, and is worth popularizing and applying.

关 键 词：透明质酸钠 膝关节镜 关节清理 髌股关节炎 膝前痛 

分 类 号：R681.8[医药卫生—骨科学]