超声引导下关节腔内注射高渗葡萄糖溶液治疗高原地区膝关节骨性关节炎  

Ultrasound-guided intra-articular injection of hypertonic glucose for treating knee osteoarthritis in plateau area

作　　者：陈伟文 唐亚群 加央扎西 谢文杰 吕涛 旺堆 赵琴 张恒 黄静 CHEN Weiwen;TANG Yaqun;Jiayangzhaxi;XIE Wenjie;LYU Tao;WANG Dui;ZHAO Qin;ZHANG Heng;HUANG Jing(Department of Ultrasound,Zhuhai People's Hospital,Zhuhai 519000,China;Department of Anesthesiology,Milin County People's Hospital,Linzhi 860500,China;Department of Orthopaedics,Zhuhai People's Hospital,Zhuhai 519000,China;Department of Surgery,Milin County People's Hospital,Linzhi 860500,China)

机构地区：[1]珠海市人民医院超声科,广东珠海519000 [2]米林县人民医院疼痛科,西藏林芝860500 [3]珠海市人民医院骨科,广东珠海519000 [4]米林县人民医院外科,西藏林芝860500

出　　处：《中国医学影像技术》2024年第1期107-111,共5页Chinese Journal of Medical Imaging Technology

基　　金：珠海市社会发展领域科技计划项目(ZH22036201210037PWC)。

摘　　要：目的观察以超声引导下关节腔内注射高渗葡萄糖(HG)治疗高原地区膝关节骨性关节炎的价值。方法纳入91例高原地区膝关节骨性关节炎患者共124个病变膝关节,根据治疗药物将膝关节分为20%HG组(n=67)、25%HG组(n=42)及玻璃酸钠组(n=15);比较治疗前、后临床及超声评分,评估疗效。结果治疗后第12、48周,3组视觉模拟评分法(VAS)评分均较治疗前降低(P均<0.05),20%HG组和25%HG组Lysholm评分均较治疗前升高(P均<0.05)。25%HG组治疗前与治疗后第12周Lysholm评分差值、治疗前与治疗后第48周VAS评分差值均高于20%HG组(P均<0.05)。20%HG组治疗后第48周关节渗出评分较治疗前降低(P<0.05),治疗后第12及48周滑膜血流评分较治疗前降低(P均<0.05);25%HG组治疗后第48周关节渗出评分较治疗前降低(P<0.05),治疗后第12及48周滑膜增生和滑膜血流评分均较治疗前降低(P均<0.05);玻璃酸钠组治疗后第48周关节渗出评分较治疗前降低(P<0.05),治疗后第12及48周滑膜增生评分均较治疗前降低(P均<0.05)。结论超声引导下关节腔内注射HG、尤其注射25%HG对于治疗高原地区膝关节骨性关节炎具有一定价值。Objective To observe the value of ultrasound-guided intra-articular injection of hypertonic glucose(HG)for treating knee osteoarthritis in plateau area.Methods Ninety-one patients with knee osteoarthritis in plateau area(124 affected knee joints)were enrolled.The knee joints were divided into 20%HG group(n=67),25%HG group(n=42)or sodium hyaluronate group(n=15)based on the medication.Clinical and ultrasound scores were compared before and after treatment,and the efficacy of injection of HG was evaluated.Results At the 12th and 48th weeks after treatment,visual analog scale(VAS)scores decreased in all 3 groups(all P<0.05),and Lysholm scores of 20%HG group and 25%HG group increased compared to those before treatment(all P<0.05).The difference of Lysholm score before and in the 12th week after treatment,and of VAS score before and in the 48th week after treatment of 25%HG group were higher than those of 20%HG group(both P<0.05).The joint exudation score of 20%HG group decreased in the 48th week after treatment compared to that before treatment(P<0.05),and the synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to those before treatment(both P<0.05).The joint exudation score of 25%HG group decreased in the 48th week after treatment compared to that before treatment(P<0.05),and the synovial hyperplasia and synovial blood flow score decreased in the 12th and 48th weeks after treatment compared to before treatment(all P<0.05).The joint exudation score of sodium hyaluronate group decreased in the 48th week after treatment compared to that before treatment(P<0.05),and the synovial hyperplasia score decreased in the 12th and 48th weeks after treatment compared to that before treatment(both P<0.05).Conclusion Ultrasound-guided intra-articular injection of HG,esp.25%HG,had certain value for treating knee osteoarthritis in plateau area.

关 键 词：骨关节炎 膝 葡萄糖 超声检查 

分 类 号：R684.3[医药卫生—骨科学] R445.1[医药卫生—外科学]