水针刀、小针刀与玻璃酸钠关节腔内注射治疗膝骨性关节炎的疗效比较  

Effects of injection needle scalpel,small needle scalpel and sodium hyaluronate intraarticular injectionon knee osteoarthritis:a comparative study

作　　者：闫振界[1] 孙洪林 赵领峰 王换新[1] YAN Zhenjie;SUN Honglin;ZHAO Lingfeng;WANG Huanxin(Department of Emergency Surgery,Zhengzhou Second People′s Hospital,Zhengzhou 450000,China;不详)

机构地区：[1]郑州市第二人民医院急诊外科,郑州450000 [2]郑州市中医院骨伤科,郑州450007 [3]郑州中泰创伤手外科医院骨科,郑州450000

出　　处：《实用医学杂志》2023年第5期591-596,共6页The Journal of Practical Medicine

基　　金：国家自然科学基金项目(编号:81173333,81001590);院内协同参与科研项目(编号:201703)。

摘　　要：目的 比较水针刀、小针刀与玻璃酸钠关节腔内注射治疗早中期膝骨性关节炎(knee osteoarthritis,KOA)的疗效。方法 156例KOA患者随机分为3组:A组(n=52)采用小针刀治疗;B组(n=52)采用玻璃酸钠关节腔内注射;C组(n=52)采用水针刀治疗。3组均每周治疗1次,连续3次。于术前、术后3、10、20 d、1个月、3个月和6个月,检测3组患者膝关节疼痛视觉模拟量表评分(VAS)及Lysholm膝关节评分;于治疗前和治疗后1个月检测膝关节活动度;治疗后1个月评定临床疗效。结果 C组的VAS疼痛评分均低于A组、B组(均P <0.001);C组Lysholm膝关节评分均高于A组、B组(均P <0.001);C组膝关节活动度均大于A组和B组(均P <0.001);C组疗效优于A组(P=0.011)和B组(P=0.009);总有效率高于A组(P=0.006)和B组(P=0.013)。治疗后3 d、10 d、20 d、1个月,B组的VAS疼痛评分均低于A组(均P <0.001);Lysholm膝关节评分均高于A组(均P <0.0167);治疗后3个月时A组和B组VAS疼痛评分、Lysholm膝关节评分比较差异无统计学意义(P> 0.05);治疗后6个月时,A组的VAS疼痛评分低于B组(均P <0.001),Lysholm膝关节评分均高于B组(均P <0.001);A组总有效率高于B组(χ2=8.409,P=0.015)。结论 对于早中期KOA患者,水针刀疗效优于小针刀与玻璃酸钠关节腔内注射;小针刀总有效率高于玻璃酸钠关节腔内注射;玻璃酸钠关节腔内注射起效比小针刀快,小针刀比玻璃酸钠的疗效持续时间长。Objective To compare the effects of injection needle scalpel,small needle scalpel and sodi⁃um hyaluronate intraarticular injection in the treatment of knee osteoarthritis(KOA).Methods One hundred and fifty⁃six patients with KOA were randomly divided into three groups in equal number:groups A,B and C(n=52),treated with small needle knife treatment,intraluminal injection of sodium hyaluronate and injection needle scalpel once a week for three consecutive times,respectively.The Visual Analogue Scale(VAS)and Lysholm Knee Scale(LKS)were used for the evaluation at the time points:before operation,3 days,10 days,20 days,1 month,3 months and 6 months after operation.The knee joint range of motion(ROM)was measured before treatment and 1 month after treatment.The curative effect was evaluated 1 month after treatment.Results(1)The VAS pain scores in group C were significantly lower than those in groups A and B(both P<0.001).The LKS score in group C was significantly higher than that of groups A and B(both P<0.001).The range of motion of knee joint in group C was greater than that of groups A and B(both P<0.001).The curative effect of group C was better than that of group A(P=0.011)and group B(P=0.009).The total effective rate of group C was higher than that of group A(P=0.006)and group B(P=0.013).(2)At days 3,10,20,and 1 month after treatment,the VAS score of group B was lower than that of group A(P<0.001);The LKS score in group B was higher than that in group A(P<0.001,<0.001,<0.001,=0.005 for different time points).Three months after treatment,there was no significant difference in VAS score and LKS score between group A and group B(P=0.302,P=0.469).Six months after treatment,the VAS scores in group A were lower than those in group B(both P<0.001).The LKS score of group A was higher than that of group B(P<0.001).The total effective rate of group A was higher than that of group B(χ2=8.409,P=0.015).Conclusion Injection needle scalpel is better than small needle scalpel and sodium hyaluronate intraluminal injection in t

关 键 词：膝骨性关节炎 水针刀 小针刀 玻璃酸钠 关节腔内注射 关节功能 

分 类 号：R684.3[医药卫生—骨科学] R246.9[医药卫生—外科学]