关节腔内注射透明质酸联合静态牵伸锻炼治疗肘关节创伤后关节僵硬的效果  

Curative effect of intraarticular injection of hyaluronic acid combined with static stretching exercise on joint stiffness after elbow trauma

作　　者：陈天昊 钟洲[2] 滕林 钟刚[2] CHEN Tian-hao;ZHONG Zhou;TENG Lin;ZHONG Gang(West China Clinical Medical College,West China Hospital,Chengdu 610041;Department of Orthopedics,West China Hospital,Chengdu 610041;Department of Orthopedics,West China Airport Hospital,Sichuan University,Chengdu 610200,Sichuan,China)

机构地区：[1]四川大学,华西临床医学院,四川成都610041 [2]四川大学,华西医院骨科,四川成都610041 [3]四川大学,华西空港医院骨科,四川成都610200

出　　处：《川北医学院学报》2024年第1期67-70,共4页Journal of North Sichuan Medical College

基　　金：四川省成都市卫生健康委员会项目(2022164)。

摘　　要：目的:观察关节腔内注射透明质酸联合静态牵伸锻炼治疗肘关节创伤后关节僵硬的效果。方法:选取102例创伤后肘关节僵硬患者为研究对象,根据治疗方式不同将患者分为对照组和观察组,每组各51例。对照组患者采用静脉牵伸锻炼治疗,3次/周;观察组患者在对照组基础上于关节腔内注射透明质酸钠治疗,1次/周,疗程均为4周。比较两组患者肘关节功能(Mayo肘关节功能评分)、肘关节运动范围、疼痛程度[视觉模拟(VAS)评分]、炎症因子[白细胞介素1β(IL-1β)、肿瘤坏死因子α(TNF-α)及C反应蛋白(CRP)]水平及疗效。结果:治疗4周后,观察组患者Mayo肘关节功能评分高于对照组(P<0.05);肘关节活动范围大于对照组(P<0.05);治疗2周、4周后,观察组VAS评分均低于对照组(P<0.05);IL-1β、TNF-α及CRP水平低于对照组(P<0.05);治疗总有效率高于对照组(94.12%vs.80.39%,P<0.05)。结论:关节腔内注射透明质酸联合静态牵伸锻炼治疗肘关节创伤后关节僵硬,可有效改善肘关节功能,缓解患者疼痛情况,降低炎症,提高治疗效果。Objective:To observe the curative effect of intraarticular injection of hyaluronic acid combined with static stretching exercise on joint stiffness after elbow trauma.Methods:A total of 102 patients with joint stiffness after elbow trauma were selected and divided into control group(static stretching exercise,3 times a week)and observation group(intraarticular injection of hyaluronic acid on basis of control group,once a week)according to different treatmnet methods,51 cases in each group.All patients received treatment for 4 weeks.The changes in scores of elbow joint function(Mayo elbow joint function score),elbow range of motion,pain level[Visual Analog Scale(VAS)score],inflammatory factors[interleukin-1β(IL-1β),tumor necrosis factorα(TNF-α),C-reactive protein(CRP)]and therapeutic effects were compared between the two groups.Results:After 4 weeks of treatment,score of Mayo elbow function in observation group was higher than that in control group(P<0.05),and elbow range of motion was greater than that in control group(P<0.05);After 2 and 4 weeks of treatment,scores of VAS in observation group were lower than those in control group(P<0.05);The levels of IL-1β,TNF-αand CRP in observation group were lower than those in control group(P<0.05).The total response rate of treatment of observation group was higher than that of the control group(94.12%vs.80.39%,P<0.05).Conclusion:Intraarticular injection of hyaluronic acid combined with static stretching exercise can significantly improve elbow function,relieve pain,reduce inflammation and improve curative effect in patients with joint stiffness after elbow trauma.

关 键 词：透明质酸 静态牵伸锻炼 肘关节创伤 关节僵硬 

分 类 号：R684.7[医药卫生—骨科学]