关节腔内注射配合微波治疗军事训练膝关节创伤性滑膜炎的疗效观察  

Effects of intra-articular injection combined with microwave therapy in the treatment of traumatic synovitis of knee joint induced by military training

作　　者：熊川 陈李伟 龚柯僖 XIONG Chuan;CHEN Liwei;GONG Kexi(Department of Military Medicine and Special Discipline,Sichuan PAP Corps Hospital,Leshan 614000,Sichuan,China)

机构地区：[1]武警四川省总队医院军事医学与特种学科,乐山614000

出　　处：《医学研究与战创伤救治》2024年第4期392-396,共5页Journal of Medical Research & Combat Trauma Care

基　　金：四川省基层卫生事业发展中心项目(SWFZ20-Y-021);乐山市科技计划项目(20SZD083)。

摘　　要：目的探究关节腔内注射配合微波治疗军事训练膝关节创伤性滑膜炎的疗效。方法选取2020年3月至2022年5月于武警四川总队医院住院治疗的因军事训练致膝关节急性创伤性滑膜炎患者60例,用随机数表法分为对照组(30例)和观察组(30例);对照组关节腔内注射玻璃酸钠配合微波治疗,观察组关节腔内注射富血小板血浆(PRP)配合微波治疗。比较2组短期疗效,采用麦克马特斯大学骨关节炎指数(WOMAC)评估膝关节功能,疼痛视觉模拟评分(VAS)评估疼痛程度,彩超测量膝关节滑膜厚度和腔内积液深度,酶联免疫法检测血清骨保护素(OPG)、软骨寡聚基质蛋白(COMP)、转化生长因子-β1(TGF-β1)、骨形态发生蛋白4(BMP4)、白细胞介素6(IL-6)和肿瘤坏死因子α(TNF-α)。结果观察组和对照组治疗总有效率为96.67%(29/30)、83.33%(25/30),差异无统计学意义(P>0.05)。治疗后观察组WOMAC评分、VAS评分、膝关节滑膜厚度、腔内积液深度、血清COMP、IL-6和TNF-α低于对照组,OPG、TGF-β1和BMP4高于对照组(均P<0.05)。随访6个月,观察组与对照组复发率的比较,差异无统计学意义(0 vs 16.67%,P>0.05)。结论关节腔内注射PRP配合微波治疗可有效提升军事训练膝关节创伤性滑膜炎患者膝关节功能,减轻疼痛,可能与改善骨代谢、促创伤修复及减轻炎症有关。Objective To explore the Effects of intra-articular injection combined with microwave therapy in the treatment of traumatic synovitis of knee joint induced by military training.Methods A total of 60 patients with acute traumatic knee synovitis induced by military training in Sichuan PAP Corps Hospital were selected and divided into a control group(30 cases)and an observation group(30 cases)from March 2020 to May 2022 by random number table method.The control group received intra-articular injection of sodium hyaluronate combined with microwave therapy,and the observation group received intra-articular injection of platelet-rich plasma(PRP)combined with microwave therapy.The short-term curative effect was compared between the two groups.The knee function was evaluated by Western Ontario and McMaster Universities osteoarthritis index(WOMAC),pain degree was evaluated by visual analogue scale(VAS),knee synovial thickness and depth of intracavitary effusion were measured by color ultrasound.The levels of serum osteoprotegerin(OPG),cartilage oligomeric matrix protein(COMP),transforming growth factor-β1(TGF-β1),bone morphogenetic protein 4(BMP4),interleukin 6(IL-6)and tumor necrosis factorα(TNF-α)were detected by enzyme-linked immunosorbent assay.Results There was no significant difference in total response rate of treatment between observation group and control group[96.67%(29 cases/30 cases)vs 83.33%(25 cases/30 cases),P>0.05].After treatment,WOMAC and VAS scores,knee synovial thickness,depth of intracavity effusion,and levels of serum COMP,IL-6 and TNF-αof the observation group were lower than those of the control group,while levels of OPG,TGF-β1 and BMP4 of the observation group were higher than those of the control group(P<0.05).After 6 months of follow-up,there was no significant difference in recurrence rate between the observation group and the control group(0 vs 16.67%,P>0.05).Conclusion Intra-articular injection of PRP combined with microwave therapy can effectively improve knee function and relieve pain

关 键 词：军事训练 膝关节创伤性滑膜炎 富血小板血浆 关节腔内注射 微波治疗 疗效 

分 类 号：R684.3[医药卫生—骨科学]