关节腔注射玻璃酸钠及醋酸曲安奈德对腘窝囊肿术后复发率的影响  

The effect of triamcinolone acetonide combined sodium hyaluronate by intra-articular injection on recurrence rate of postoperative popliteal cyst

作　　者：方成[1] 赵文[1] 魏朝阳[1] 江昭林[1] 周忠鸿[1] FANG Cheng;ZHAO Wen;WEI Chao-yang;JIANG Zhao lin;ZHOU Zhong-hong(The Chinese people＇s Liberation Army Navy of Anqing hospital,Department of orthopedics,Anhui Anqing 246003,Chin)

机构地区：[1]中国人民解放军海军安庆医院骨外科,安徽安庆246003

出　　处：《临床医药文献电子杂志》2018年第34期37-39,41,共4页Electronic Journal of Clinical Medical Literature

摘　　要：目的探讨玻璃酸钠及醋酸曲安奈德注射液行关节腔注射,对腘窝囊肿术后复发率的影响。方法选取2013年6月~2016年8月收治的68例腘窝囊肿患者,根据随机数字表法分为A、B两组,A组(观察组)38例患者行腘窝囊肿切除术后第1、2周关节腔注射玻璃酸钠及醋酸曲安奈德,术后第3、4周注射玻璃酸钠,每周一次;B组(对照组)30例患者术后不做任何处理。68例患者均获得随访,术后3、6、12月及每年随访1次,复查膝关节MRI明确有无复发。末次随访时根据VAS评分、Rauschning和Lindgren评分和Lysh olm评分等综合评价两种治疗方案的临床疗效,并统计术后复发率。结果随访6-36个月期间A组2例复发,复发率(5.26%),B组6例复发,复发率(20%),两组之间差异有统计学意义(P<0.05)。根据VAS评分:A组术后平均(2.04±1.32)分,B组术后平均(4.18±2.84)分(P<0.05)。Rauschning和Lindgren分级评分,A组优良率94.5%,B组优良率66.7%(P<0.05)。Lysholm评分:A组术后平均(86.25±11.34)分,B组术后平均(68.50±10.86)分(P<0.05)。结论玻璃酸钠联合醋酸曲安奈德显著降低腘窝囊肿术后复发率,疗效好,优于单纯开放手术,临床推广方便。Objective To explore if triamcinolone acetonide combined sodium hyaluronate by intra-articular injection reduced recurrence of popliteal cyst after open popliteal cystectomy.Methods From 2013.6-2016.8,68 cases of popliteal cyst patients wre randomly divided into 2 groups（group A and B）.38 patients（group A） underwent resection of popliteal cyst first to second weeks after intra-articular injection of sodium hyaluronate and triamcinolone acetonide,after third to fourth weeks of injection of sodium hyaluronate, once a week. 30 patients（group B） was no treatment after operation.MRI examination of knee joint in outpatient department to make clear whether the popliteal recurs or not during the 3,6,12-month follow-up period.Evaluation of therapeutic effect according to visual analogue scale,Rauschning and Lindg ren scores and Lysholm scores at the last follow-up.Results In group A, 2 cases relapsed, and the recurrence rate was 5.26%,and 6 cases relapsed, and the recurrence rate was 20% in group B during the follow-up period.The difference between the two groups was statistically significant（P〈0.05）.According to the VAS score：the average score of two groups after operation, group A was（2.04±1.32） and group B was（4.18±2.84）（P〈0.05）.According to the Rauschning and Lindgren scores：the an eligible ra te of two groups after o peration,group A was 94.5% and group B was 66.7%（P〈0.05）.Acc ording to the Lysholm score： the average score of group A after operation, group A was（86.25±11.34） and group B was（68.50±10.86）（P〈0.05）.Conclusion Sodium hyaluronate combined triamcinolone acetonide acetate significantly reduced popliteal cyst recurrence rate,good curative effect,clinical application was convenient.

关 键 词：窝囊肿 复发率 协同效应 醋酸曲安奈德 

分 类 号：R684[医药卫生—骨科学]