超声及放射线影像检查引导膝关节周围神经射频消融与关节内注射治疗膝关节骨性关节炎的临床疗效  

Clinical efficacy of radiofrequency ablation and intra-articular injection guided by ultrasound and radiographic imaging in the treatment of knee osteoarthritis

作　　者：卿帅[1] 黄世明 衣起山 QING Shuai;HUANG Shi-Ming;YI Qi-Shan(Pain department,The First People's Hospital of Yibin,Yibin 644000,Sichuan,China)

机构地区：[1]宜宾市第一人民医院疼痛科,四川宜宾644000

出　　处：《吉林医学》2025年第2期335-340,共6页Jilin Medical Journal

基　　金：宜宾市卫健委项目[项目编号:2021YW0006]。

摘　　要：目的:探讨超声及放射线影像检查引导膝关节周围神经射频消融与关节内激素注射治疗膝关节骨性关节炎的临床疗效。方法:选取90例慢性膝关节骨性关节炎患者为研究对象随机分为U组(超声引导膝关节周围神经射频消融,n=30)、X组(放射线影像检查引导膝关节周围神经射频消融,n=30)和Ⅰ组(膝关节腔注射1%利多卡因10 ml及倍他米松2 mg,n=30)。比较三组患者治疗前、治疗后1周、治疗后4周、治疗后12周、治疗后24周视觉疼痛模拟评分法(VAS)、膝关节Lyshom(LKS)评分及美国膝关节协会(AKS)评分。结果:与治疗前比较,U组及X组患者在治疗后1周、治疗后4周、治疗后12周、治疗后24周各时段的VAS评分明显更低(P<0.05)、LKS及AKS评分更高(P<0.05),Ⅰ组患者在治疗后1周、治疗后4周、治疗后12周各时段的VAS明显更低,差异有统计学意义(P<0.05);LKS评分及AKS评分更高,差异有统计学意义(P<0.05);与Ⅰ组比较,U组及X组患者治疗后4周、治疗后12周、治疗后24周各时段的VAS评分明显更低,差异有统计学意义(P<0.05),LKS评分及AKS评分更高,差异有统计学意义(P<0.05);U组及X组患者在各时段VAS评分、LKS评分及AKS评分比较差异无统计学意义(P>0.05)。结论:与关节内注射激素比较,膝关节周围神经射频消融更能有效降低膝关节骨性关节炎患者的疼痛和改善功能;超声引导及放射线影像检查引导膝关节周围神经射频消融治疗膝关节骨性关节炎的疗效无差别。Objective To investigate the clinical efficacy of ultrasound-guided radiofrequency ablation of peripheral nerves around the knee joint and intra-articular hormone injection in the treatment of knee osteoarthritis.Method 90 patients with chronic knee osteoarthritis were randomly divided into Group U(ultrasound-guided radiofrequency ablation of the knee joint peripheral nerves,n=30),Group X(guided radiofrequency ablation of the knee joint peripheral nerves by radiographic examination,n=30),and GroupⅠ(injection of 10 ml lidocaine and 2 mg betamethasone into the knee joint cavity,n=30).Compare VAS scores,LKS scores,and AKS scores of three groups of patients before treatment,1 week,4 weeks,12 weeks,and 24 weeks after treatment.Results Compared with before treatment,The VAS scores of patients in Group U and Group X were significantly lower(P<0.05)at 1 week,4 weeks,12 weeks,and 24 weeks after treatment,while the LKS and AKS scores were higher(P<0.05).The VAS scores of patients in GroupⅠwere significantly lower(P<0.05)at 1 week,4 weeks,and 12 weeks after treatment,while the LKS and AKS scores were higher(P<0.05);Compared with group I,patients in groups U and X had significantly lower VAS scores(P<0.05),higher LKS scores,and AKS scores(P<0.05)at 4,12,and 24 weeks after treatment;There was no statistically significant difference(P>0.05)in VAS scores,LKS scores,and AKS scores between patients in group U and group X.Conclusion Compared with intra-articular hormone injection,radiofrequency ablation of knee joint peripheral nerves is more effective in reducing pain and improving function in patients with knee osteoarthritis;There is no difference in the efficacy of ultrasound-guided and radioimage-guided radiofrequency ablation of peripheral nerves in the treatment of knee osteoarthritis.

关 键 词：超声 膝关节周围神经 射频消融 膝关节骨性关节炎 

分 类 号：R68[医药卫生—骨科学]