几丁糖与透明质酸钠治疗肘关节粘连的对比研究  

Comparison Study of Chitosan and Hyaluronate Sodium in the Treatment of Elbow Adhesion

作　　者：陈爱民[1] 侯春林[1] 陈庆泉[1] 斯清庆[1] 王永胜[1] 刘岩[1] 张伟[1] 匡勇[1] 欧阳跃平[1] 王诗波[1] 尹承慧[1] 郑金龙[1] 

机构地区：[1]第二军医大学附属长征医院骨科,上海200003

出　　处：《中国矫形外科杂志》2002年第13期1289-1291,共3页Orthopedic Journal of China

基　　金：国家自然科学基金资助 (No :39570 712 )

摘　　要：目的 :比较医用几丁糖与透明质酸钠预防肘关节粘连的临床疗效。方法 :对 43例肘关节僵硬患者进行手术松解 ,其中 1 5例术后关节腔内涂布 2 %几丁糖 ,1 4例术后关节腔内涂布 1 %透明质酸钠 ,另 1 4例术后关节腔内涂布生理盐水为对照组 ,观察术后肘关节伸屈活动度改善程度以评定疗效。结果 :本组病例均获随访 ,随访时间 1 0～ 87月 ,平均 42月。几丁糖组术后肘关节平均活动度恢复到 (97.7± 1 6 .5)° ,比术前增加 (62 .0± 1 2 .7)° ;透明质酸钠组术后肘关节平均活动度恢复到 (86 .1± 1 8.6)°,比术前增加 (48.9± 1 5 .1 )°,对照组术后肘关节平均活动度恢复到 (70 .0± 1 5 .1 )°,比术前增加 (36 .1± 1 1 .5°)。几丁糖组术后肘关节伸屈活动度增值大于透明质酸钠组 (P <0 .0 5) ,透明质酸钠组术后肘关节伸屈活动度增值大于对照组 (P <0 .0 5)。结论 :医用几丁糖和透明质酸钠均具有减轻或预防肘关节松解术后再粘连的形成作用 。Objective:To study the clinical effect of chit osan and hyaluronate sodium on prevention of elbow adhesion after elbow arthroly sis.Method:Forty patients were divided into three groups.In chitosan group,15 p atie nts after arthrolysis accepted an injection of 2%chitosan into the elbow joint c avity.In hyaluronate sodium group,14 patients after arthrolysis accepted an inje ction of 1% hyaluronate sodium into the elbow joint cavity.There was no chitosa n or hyaluronate sodium used in 14 patients as control group.The average range o f extension and flexion of elbow joint was detected to evaluate the results.Resu lts:All patients were followed up.The follow up time were 42(10～87) months.In t h e chitosan group,the average range of extension and flexion of elbow joint was r estored to 97.7±16.5°,with an average increase of 62.0±12.7°.In the hyaluron a te sodium group,the average range of extension and flexion of elbow joint was re stored to 86.1±18.6°,with an average increase of 48.9±15.1°.In the control group,the co rresponding figures were 70.0±15.1°and 36.1±11.5°.The outcome in the chitosa n group was significantly better than that in the control.The outcome in the chi tosan group was significantly better than that in the hyaluronate sodium group( P< 0.05),and in the hyaluronate sodium group better than that in the contro l group( P <0.05).Conclusion:Both chitosan and hyaluronate sodium can preven t or reduce elbow adhesion after elbow arthrolysis,and chitosan is more effectiv e than hyaluronate sodium.

关 键 词：几丁糖 透明质酸钠 治疗 肘关节粘连 对比研究 

分 类 号：R684.8[医药卫生—骨科学]