全膝关节置换术与微创单髁置换术治疗膝骨关节炎患者的临床效果  

Clinical Effects of Total Knee Arthroplasty and Minimally Invasive Unicondylar Knee Arthroplasty in the Treatment of Knee Osteoarthritis

作　　者：胡光东 HU Guangdong(Department of Orthopaedics,Qihe County Hospital of Traditional Chinese Medicine,Dezhou 251100,China)

机构地区：[1]齐河县中医院骨科,山东德州251100

出　　处：《反射疗法与康复医学》2024年第21期129-132,共4页Reflexology And Rehabilitation Medicine

摘　　要：目的比较全膝关节置换术(TKA)与微创单髁置换术(MI-UKA)治疗膝骨关节炎(KOA)的临床效果。方法选取齐河县中医院2022年1月—2023年12月收治的82例KOA患者为研究对象,按随机数字表法将其分为对照组和观察组,各41例。对照组行TKA治疗,观察组行MI-UKA治疗。比较两组的手术情况、疼痛程度、膝关节功能、关节活动度、应激水平及并发症发生情况。结果观察组手术时间、住院时间均短于对照组,术中失血量少于对照组,组间差异有统计学意义(P<0.05)。术后6个月,观察组疼痛视觉模拟评分低于对照组,差异有统计学意义(P<0.05);两组西安大略和麦克马斯特大学骨关节炎指数各个维度评分、总分及关节活动度对比,组间差异无统计学意义(P>0.05)。术后24 h,观察组皮质醇、促肾上腺皮质激素、去甲肾上腺素水平均低于对照组,组间差异有统计学意义(P<0.05)。两组并发症发生率对比,差异无统计学意义(P>0.05)。结论TKA与MI-UKA均可加快KOA患者的膝关节功能恢复,但MI-UKA的创伤更小,出血量更少,有利于减轻应激反应,且安全性高。Objective Comparison of clinical efficacy between total knee arthroplasty(TKA)and minimally invasive unicondylar knee arthroplasty(MI-UKA)in the treatment of knee osteoarthritis(KOA).Methods A total of 82 KOA patients admitted to Qihe County Hospital of Traditional Chinese Medicine from January 2022 to December 2023 were selected as the research subjects,according to the random number table method,they were divided into a control group and an observation group,with 41 cases in each group.The control group received TKA treatment,while the observation group received MI-UKA treatment.Compare the surgical situations,pain levels,knee joint function,joint mobility,stress level and occurrence of complications between two groups.Results The surgery time and hospitalization time of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group,the differences between the groups were statistically significant(P<0.05).Six months after surgery,the pain Visual Analogue Scale score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05);comparison of scores,total scores,and joint range of motion for each dimension of Western Ontario and McMaster Universities Osteoarthritis Index between two groups,there were no statistically significant differences between groups(P>0.05).24 hours after surgery,the levels of cortisol,adrenocorticotropic hormone,and norepinephrinein the observation group were lower than those in the control group,the differences between the groups were statistically significant(P<0.05).Comparison of incidence of complications between two groups,the difference was not statistically significant(P>0.05).Conclusion Both TKA and MI-UKA can accelerate the recovery of knee joint function in patients with KOA,but MI-UKA has less trauma,less bleeding,is beneficial for reducing stress response,and has high safety.

关 键 词：膝骨关节炎 全膝关节置换术 微创单髁置换术 膝关节活动度 并发症 

分 类 号：R684.3[医药卫生—骨科学]