不同部位注射玻璃酸钠治疗髌股关节炎临床疗效观察  

Lateral midpatellar approach versus anteralateral approach for sodium hyaluronate intraarticular injection in treatment of patellofemoral osteoarthritis

作　　者：王琪 李众利[2] 刘玉杰[2] 王志刚[2] 魏民[2] 王昊 王景贵 夏群 刘爱鹏 刘勇 WANG Qi;LI Zhongli;LIU Yujie;WANG Zhigang;WEI Min;WANG Hao;WANG Jinggui;XIA Qun;LIU Aipeng;LIU Yong(Department of Orthopedics,Specialized Medical Center of Chinese People's Armed Police Force,Tianjin 300162,China;Department of Orthopedics,the First Medical Center,Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]武警特色医学中心骨科,天津300162 [2]解放军总医院第一医学中心骨科,北京100853

出　　处：《解放军医学院学报》2019年第4期333-337,共5页Academic Journal of Chinese PLA Medical School

摘　　要：目的观察膝关节髌股关节间隙和膝眼两个部位注射玻璃酸钠对膝关节髌股关节炎的疗效及应用特点。方法选择2017年2月-2018年4月在武警特色医学中心骨科接受关节腔玻璃酸钠注射治疗的膝关节髌股关节炎患者64例,根据注射位点不同,依据就诊顺序按随机数字表法分为髌股关节间隙注射组(34例)和膝眼注射组(30例)。两组均接受剂量为2.5ml/次,1次/周,连续5周的膝关节腔玻璃酸钠注射治疗。比较两组患者治疗前后的VAS评分、Lysholm评分及治疗后优良率。结果两组治疗后VAS评分均较治疗前降低,Lysholm评分均较治疗前升高(P<0.05)。首次注射后和注射3周后,髌股关节间隙注射组VAS评分显著低于膝眼注射组(P<0.05)。注射3周后及注射后3个月,髌股间隙注射组Lysholm评分高于膝眼注射组(P<0.05)。注射5周后及注射后3个月髌股间隙注射组优良率略高于膝眼注射组(85.29%vs76.67%;85.29%vs80.00%,P>0.05)。结论髌股关节间隙注射玻璃酸钠治疗膝关节髌股关节炎早期和长期临床效果优于膝眼注射法。Objective To observe the therapeutic effects of sodium hyaluronate (SH) intra-articular injection via lateral midpatellar approach versus anteralateral approach in treatment of patellofemoral osteoarthritis.Methods Sixty-four patients with knee patellofemoral osteoarthritis in department of orthopedics of Specialized Medical Center of the Chinese People's Armed Police Force from February 2017 to April 2018 were randomly divided into lateral midpatellar approach group [n=34,16 males and 18 females with average age of (53.7±6.5) years (ranging from 39 to 82 years)],and anteralateral approach group [n=30,14 males and 16 females with average age of (51.6±5.7) years (ranging from 36 to 80 years)] using random table method.Patients in two groups were respectively treated with intra-articular injection of sodium hyaluronate (SH)(2.5 ml/time,once weekly,for 5 weeks) via lateral midpatellar approach or anteralateral approach.After treatment,the VAS scores,Lysholm scores and clinical effect were evaluated and compared between two groups.Results The VAS score decreased,and Lysholm score increased significantly over time after treatment in two groups (P < 0.05,respectively).After the first and the third injections,the VAS scores in lateral midpatellar approach group were significantly lower than those in anteralateral approach group [(5.50±1.14) vs 6.1±0.92,P =0.025;(4.85±0.96) vs (5.30±0.79),P =0.044];the Lysholm scores in lateral midpatellar approach group were significantly higher than the scores in anteralateral approach group [(76.38±6.20) vs (73.33±5.37),P=0.041;(87.26±4.76) vs (84.43±4.95),P=0.023]. After the fifth injection and at three months after injection,the clinical effect in lateral midpatellar approach group was slightly superior to anteralateral approach group (85.29% vs 76.67%;85.29% vs 80.00%;P > 0.05),but the difference was not significant. Conclusion Injection of sodium hyaluronate through the lateral midpatellar approach for the treatment of patellofemoral osteoarthritis has a better clinical

关 键 词：髌股关节炎 玻璃酸钠 膝关节腔注射 髌股关节间隙注射 膝眼注射 

分 类 号：R684.3[医药卫生—骨科学]