关节镜治疗膝骨关节炎疗效影响因素的回归分析  

Regression analysis of factors affecting efficacy of arthroscopic treatment for knee osteoarthritis

作　　者：申晓坤 李发祥[1] 王维山[1] 史晨辉[1] 

机构地区：[1]石河子大学医学院第一附属医院骨科,新疆石河子832000

出　　处：《局解手术学杂志》2016年第8期585-588,共4页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(81160225;81260453;81360451);新疆兵团医药卫生专项资助(2013BA020);兵团国际交流与合作专项资助(2012BC002;2011BC004);兵团科技创新团队专项基金(2014CC002)

摘　　要：目的探讨关节镜清理术治疗膝关节骨性关节炎疗效的影响因素。方法回顾性分析2009年1月至2013年12月我院骨科收治的202例224膝行关节镜清理术治疗的膝骨关节炎患者的临床资料,以Lysholm评分评价治疗效果,并选取可能影响疗效的因素先进行单因素分析,单因素分析后有统计学意义的再进行多因素Logistic回归分析。结果单因素分析显示:年龄、病程、体质指数、心理因素、术前VAS疼痛评分、术前Kellgren-Lawrence分级、术前Lysholm评分、术后康复锻炼影响膝关节镜治疗膝骨性关节炎的疗效,组间比较,差异有统计学意义(P<0.05)。进一步多因素分析显示体质指数高、术前VAS疼痛评分高、术前Lysholm评分低、心理期望值高、术前Kellgren-Lawrence分级高是影响膝关节镜治疗膝骨关节炎疗效的独立危险因素,术后严格遵守康复锻炼是保护因素。结论体质指数高、术前VAS疼痛评分高、术前Lysholm评分低、心理期望值高、术前Kellgren-Lawrence分级高会降低手术疗效,术后严格遵守康复锻炼可以提高手术疗效。Objective To investigate the factors that affecting the efficacy of arthroscopic debridement in the treatment of knee osteoarthfitis. Methods The clinical data of patients with knee osteoarthritis treated with arthroscopic debridement in our hospital from January 2009 to December 2013 was retrospectively analyzed, and the treatment effect was evaluated by Lysholm score. The factors that may affect the efficacy were selected to make a single factor analysis, and then made a multiple logistic regression analysis with the factors which were of sta- tistical significance through single factor analysis. Results Single factor analysis showed that age, course of disease, body mass index, psycho- logical factor, preoperative VAS score, preoperative Kellgren-Lawrence grade, preoperative Lysholm score and postoperative rehabilitation exercise were the factors that affected the efficacy of knee arthroscopy in the treatment of knee osteoarthritis, and the difference between the two groups was statistically significant. Further multivariate analysis showed that high body mass index, high preoperative VAS pain score,low Ly-shalm score, high psychological expectations and high preoperative Kellgren-Lawrence grading were expected to be the independent risk factors of knee arthroscopy in the treatment of knee osteoarthrltis. Strict compliance with the postoperative rehabilitation exercise was the protect factor. Conclusion High body mass index, high preoperative VAS pain score, low preoperative Lysholm score, high preoperative Kellgren- Lawrence grading, and high psychological expectations were expected to reduce the effect of surgery, while strict compliance with the postoper-ative rehabilitation exercise can improve the curative effect.

关 键 词：膝关节骨性关节炎 关节镜清理术 影响因素 LOGISTIC回归分析 

分 类 号：R684.3[医药卫生—骨科学]