隐神经脉冲射频调节术联合透明质酸钠关节内注射治疗膝关节骨性关节炎的疗效评价  

Efficacy of saphenous nerve pulsed radiofrequency with sodium hyaluronate intra-articular injection for patients with knee osteoarthritis

作　　者：杨帆[1] 田文华 Yang Fan;Tian Wenhua(Department of Painology,Hankou Hospital,Wuhan City,Hubei Province 430012,China;Department of Painology,Hubei Provincial Rehabilitation Hospital,Wuhan City,Hubei Province 430000,China)

机构地区：[1]武汉市汉口医院疼痛科,武汉市430012 [2]湖北省康复医院疼痛科,武汉市430000

出　　处：《中华疼痛学杂志》2023年第1期87-92,共6页Chinese Journal Of Painology

摘　　要：目的评价超声引导下隐神经脉冲射频联合透明质酸钠关节内注射治疗膝关节骨性关节炎的疗效。方法收集武汉市汉口医院疼痛科2021年2月至2022年1月经保守治无效的膝关节骨性关节炎患者72例, 随机分为脉冲射频联合组(n=36)和透明质酸钠注射组(n=36)。前组行超声引导隐神经脉冲射频调节术联合透明质酸钠关节内注射2.5 ml(25 mg), 后组单纯透明质酸钠关节内注射2.5 ml(25 mg), 两组均为单次治疗。评价治疗前, 治疗后3 d、1周、1、3及6个月时膝关节VAS评分、骨关节炎指数WOMAC评分和不良反应。结果两组患者治疗后3 d时VAS评分明显低于治疗前(F=11.86, P<0.001), 治疗后1周和1、3及6个月时脉冲射频联合组VAS评分明显低于透明质酸钠注射组(F=16.87, P<0.001)。治疗后1、3及6个月时脉冲射频联合组WOMAC评分明显低于透明质酸钠注射组(F=5.86, P<0.05)。治疗后6个月时脉冲射频联合组患者优良率[88.9%(32/36例)]高于透明质酸钠注射组[61.1%(22/36例)], 差异有统计学意义(P<0.05)。结论超声引导下隐神经脉冲射频调节术联合透明质酸钠关节内注射治疗膝关节骨性关节炎能有效改善膝关节疼痛和功能障碍, 远期疗效佳。Objective To evaluate the efficacy of ultrasound-guided saphenous nerve pulse radiofrequency(RF)combined with sodium hyaluronate intra-articular injection in the treatment of patients with knee osteoarthritis.Methods From February 2021 to January 2022,72 patients with knee osteoarthritis failed conservative treatment were randomly divided into pulse radiofrequency combined group(group A,n=36)and sodium hyaluronate injection group(group B,n=36).The patients was treated by ultrasound-guided saphenous nerve pulse RF and intra-articular injection of 2.5 ml sodium hyaluronate in the group A,and by intra-articular injection of 2.5 ml sodium hyaluronate only in the group B.VAS,WOMAC score of osteoarthritis index and adverse reactions were evaluated before the treatment,3 days,1 week,1 month,3 months and 6 months after the treatment.Results At 3 days after the treatment,the VAS was significantly lower than that before the treatment(F=11.86,P<0.001)in the two groups.At 1 week,1 month,3 months and 6 months after the treatment,the VAS(F=16.87,P<0.001)and WOMAC(F=5.86,P<0.05)were significantly lower in the group A than that in the group B.At 6 months after the treatment,the excellent and good rate was higher in the group A(88.9%,32/36 cases)than that in the group B(61.1%,22/36 cases)(P<0.05).Conclusion Ultrasound-guided saphenous nerve pulse radiofrequency modulation combined with sodium hyaluronate intra-articular injection effectively improve knee pain and dysfunction,with long-term effect in the treatment of patients with knee osteoarthritis.

关 键 词：骨关节炎 膝 透明质酸 注射 关节内 超声引导 隐神经 脉冲射频 

分 类 号：R684.3[医药卫生—骨科学]