膝动脉栓塞治疗膝关节炎症性疼痛  

Genicular artery embolization for treatment of inflammatory knee pain

作　　者：周海 贾中芝[1] 王禹基[2] 陶涛[2] 陈勇[3] 王刚刚[1] 赵进委[1] ZHOU Hai;JIA Zhongzhi;WANG Yuji;TAO Tao;CHEN Yong;WANG Ganggang;ZHAO Jinwei(Department of Interventional and Vascular Surgery,the Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People’s Hospital),Changzhou,Jiangsu 213003,China;Department of Orthopedics,the Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People’s Hospital),Changzhou,Jiangsu 213003,China;Department of Pain Medicine,the Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People’s Hospital),Changzhou,Jiangsu 213003,China)

机构地区：[1]南京医科大学第三附属医院(常州市第二人民医院)介入血管科,江苏常州213003 [2]南京医科大学第三附属医院(常州市第二人民医院)骨科,江苏常州213003 [3]南京医科大学第三附属医院(常州市第二人民医院)疼痛科,江苏常州213003

出　　处：《手术电子杂志》2024年第6期51-57,共7页Electronic Journal of Medical Operations

基　　金：常州市“十四五”卫生健康高层次人才培养工程(领军人才)(2022CZLJ026)

摘　　要：目的 探讨膝动脉栓塞(GAE)治疗膝关节炎症性疼痛的疗效与安全性。方法 回顾性分析常州市第二人民医院2023年11月—2024年10月接受GAE治疗的6例膝关节炎症性疼痛患者的临床资料。采用视觉模拟评分(VAS)和西安大略和麦克马斯特大学骨关节炎指数(WOMAC)评估治疗效果。结果 共纳入6例患者(男1例,女5例),中位年龄55.5(范围:33.0~74.0)岁。病因包括:膝骨关节炎(4例)、类风湿性关节炎术后(1例)和滑膜骨软骨瘤病术后(1例)。所有患者均完成GAE术,4例患者使用Embosphere微球栓塞,2例使用亚胺培南/西司他丁粉针栓塞。栓塞剂平均用量0.8(范围:0.5~1.6)m L。1例患者栓塞后出现一过性皮肤变色,对症处理后好转。术后1月VAS评分从术前7.0(6.0~7.0)分降到术后3.0(2.0~3.0)分(P<0.05),WOMAC评分从术前58.5(44.0~76.0)分降到术后27.0(22.0~32.0)分(P<0.05)。随访1~9月,所有患者病情稳定,无手术并发症。结论 GAE可有效缓解膝关节炎症性疼痛,具有良好的安全性。Objective To investigate the efficacy and safety of genicular artery embolization(GAE)in treating inflammatory knee pain.Methods A retrospective analysis was conducted on 6 patients with inflammatory knee pain who underwent GAE between November 2023 and October 2024 in changzhou second peple's Hospital.The therapeutic effects were evaluated using Visual Analogue Scale(VAS)and Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC).Results Six patients(1 male and 5 females)with a median age of 55.5(range:33.0~74.0)years were enrolled.The etiologies included knee osteoarthritis(4 cases),post-operative rheumatoid arthritis(1 case),and post-operative synovial osteochondromatosis(1 case).GAE was successfully completed in all patients.Embosphere microspheres were used in 4 cases,and imipenem/cilastatin powder was used in 2 cases.The median volume of embolic agents was 0.8(range:0.5~1.6)mL.One patient experienced transient skin discoloration that resolved after symptomatic treatment.At one-month follow-up,the VAS score decreased from the preoperative value of 7.0(6.0~7.0)to the postoperative value of 3.0(2.0~3.0)(P<0.05),and the WOMAC score decreased from 58.5(44.0~76.0)to 27.0(22.0~32.0)(P<0.05).During the 1-9 months follow-up period,all patients remained stable without surgical complications.Conclusion GAE can effectively relieve inflammatory knee pain with good efficacy and safety.

关 键 词：膝关节 骨关节炎 膝动脉 栓塞 疼痛 

分 类 号：R684.3[医药卫生—骨科学]