骨减压联合双氯芬酸钠对小儿胫骨结节骨软骨病的疗效及安全性分析  

Efficacy and safety of bone decompression combined with diclofenac sodium in the treatment of osteochondrosis of tibial tubercle in children

作　　者：周开亮 吴声忠 黄志勇 林廉洋 董志军 Zhou Kailiang;Wu Shengzhong;Huang Zhiyong;Lin Lianyang;Dong Zhijun(Department of Orthopeadic Surgery,Guizhou Orthopedic Hospital,Guizhou Province,Guiyang 550004,China)

机构地区：[1]贵州省骨科医院骨外二病区,贵阳550004

出　　处：《疑难病杂志》2022年第1期46-49,54,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：贵阳市科技计划项目筑科合同[(20161001)29号]。

摘　　要：目的观察骨减压联合双氯芬酸钠治疗小儿胫骨结节骨软骨病的疗效及安全性。方法选取2018年5月—2021年5月于贵州省骨科医院骨外二病区收治胫骨结节骨软骨病患儿75例,随机数字表法分为药物组37例、联合组38例,药物组使用双氯芬酸钠治疗,联合组行骨减压联合双氯芬酸钠治疗。比较2组患者治疗前后膝关节功能评分(KSS)、疼痛视觉模拟评分(VAS),全血黏度、血浆黏度,血清基质金属蛋白酶-1(MMP-1)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、丙二醇(MDA)、超氧化物歧化酶(SOD)水平,评价2组疗效并记录不良反应。结果治疗后,与药物组比较,联合组患儿KSS评分升高,VAS评分降低(t/P=8.740/0.001、5.733/0.001);全血黏度、血浆黏度水平降低(t/P=4.358/0.001、3.725/0.001);SOD水平升高,MMP-1、TNF-α、IL-6、MDA水平降低(t/P=7.489/0.001、6.730/0.001、10.700/0.001、6.466/0.001、5.907/0.001)。联合组治疗总有效率高于药物组(94.74%vs.78.38%,χ^(2)/P=4.341/0.037),不良反应发生率低于药物组(2.63%vs.18.92%,χ^(2)/P=5.219/0.022)。结论胫骨结节骨软骨病患儿使用骨减压联合双氯芬酸钠治疗,患儿KSS评分升高,VAS评分降低,血液流变学得到改善,炎性反应减轻,机体抗氧化能力提升,效果显著。Objective To observe the efficacy and safety of bone decompression combined with diclofenac sodium in the treatment of osteochondrosis of tibial tubercle in children.Methods From May 2018 to may 2021,75 children with osteochondrosis of tibial tubercle were treated in the Second Ward Orthopedic Surgery of Guizhou Orthopedic Hospital.The patients were randomly divided into drug group(37 cases)and combined group(38 cases).The drug group was treated with diclofenac sodium,and the combined group was treated with bone decompression combined with diclofenac sodium.The knee function score(KSS),visual analogue scale(VAS),whole blood viscosity,plasma viscosity,matrix metalloproteinase-1(MMP-1)and tumor necrosis factor were compared between the two groups before and after treatmentα(TNF-α).The levels of interleukin-6(IL-6),propylene glycol(MDA)and superoxide dismutase(SOD),as well as the efficacy and adverse reactions of the two groups were compared.Results After treatment,compared with the drug group,the KSS score increased and the VAS score decreased in the combined group(t/P=8.740/0.001,5.733/0.001).The whole blood viscosity and plasma viscosity decreased(t/P=4.358/0.001,3.725/0.001).The level of SOD increased,MMP-1 and TNF-α.The levels of IL-6 and MDA decreased(t/P=7.489/0.001,6.730/0.001,10.700/0.001,6.466/0.001,5.907/0.001).The total effective rate of the combined group was higher than that of the drug group(94.74%vs.78.38%,χ^(2)/P=4.341/0.037),and the incidence of adverse reactions in the drug group was lower than that in the drug group(2.63%vs.18.92%,χ^(2)/P=5.219/0.022).Conclusion Children with osteochondropathy of tibial tubercle were treated with bone decompression combined with diclofenac sodium.The KSS score increased,VAS score decreased,hemorheology improved,inflammatory reaction reduced,and the antioxidant capacity of the body improved.The effect was significant.

关 键 词：骨软骨病 胫骨结节 骨减压 双氯芬酸钠 炎性反应 血液流变学 儿童 

分 类 号：R681.3[医药卫生—骨科学]