滑膜切除对全膝关节置换术后炎症因子和膝关节疼痛的影响  

Effect of synoviectomy on inflammatory factors and knee pain after total knee arthroplasty

作　　者：杨勇[1] 吉明[1] YANG Yong;JI Ming(Department of Orthopedics and Arthropathy,Chongqing Three Gorges Central Hospital,Chongqing 404000,China)

机构地区：[1]重庆三峡中心医院骨科关节病区

出　　处：《广西医学》2019年第20期2567-2570,共4页Guangxi Medical Journal

基　　金：重庆市万州区科技计划项目(w2stc-042017071)

摘　　要：目的探讨滑膜切除对全膝关节置换术后炎症因子和膝关节疼痛的影响。方法将60例择期行全膝关节置换术患者分为观察组(术中行滑膜切除)和对照组(术中未行滑膜切除),每组30例。比较两组患者术前、术后12周、12个月特种外科医院(HSS)膝关节功能评分、视觉疼痛模拟量表(VAS)评分,以及术前、术后第1天、第7天、第14天血液缓激肽、白细胞介素1β、C反应蛋白水平。记录两组患者手术时间、术中出血量、术后引流量。结果观察组的HSS膝关节功能评分、VAS评分、缓激肽、白细胞介素1β、C反应蛋白水平随时间升高或降低的趋势均优于对照组(均P<0.05)。观察组手术时间、术中出血量和术后引流量均长于或多于对照组(均P<0.05)。结论全膝关节置换术中行滑膜切除可缓解术后膝关节疼痛程度,降低炎症因子表达水平,并改善膝关节功能。Objective To investigate the effect of synoviectomy on inflammatory factors and knee pain after total knee arthroplasty.Methods Sixty patients undergoing elective total knee arthroplasty were divided into observation group(synovectomy conducted during operation) and control group(no synovectomy conducted during operation),with 30 cases in each group.The hospital for special surgery(HSS) score for knee function and Visual Analogue Scale(VAS) score before operation,at 12 weeks and 12 months after operation,as well as blood bradykinin,interleukin 1β and C-reactive protein levels before operation,on the first,seventh and fourteenth days after operation,were compared between the two group.The operation time,intraoperative bleeding volume and postoperative drainage volume of the patients in both groups were recorded.Results Rising or falling tendency of HSS score for knee function,VAS score,bradykinin level,interleukin 1β level and C-reactive protein level in the observation group were superior to the control group(all P<0.05).The operation time,intraoperative bleeding volume and postoperative drainage volume of the observation group were longer or more than those of the control group(all P<0.05).Conclusion Synoviectomy conducted in total knee arthroplasty can relieve postoperative knee pain,reduce the expressions of inflammatory factors,and improve knee function.

关 键 词：滑膜切除 全膝关节置换术 炎症因子 疼痛 膝关节 

分 类 号：R684[医药卫生—骨科学]