关节镜下有限性清理术联合透明质酸钠注射液治疗膝骨性关节炎疗效及对患者生活质量的影响
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摘要
目的:探讨关节镜下有限性清理术联合透明质酸钠注射液治疗膝骨性关节炎患者疗效及对患者生活质量的影响。方法:100例膝骨性关节炎患者随机分为观察组和对照组各50例,采用关节镜下有限性清理术治疗对照组患者,观察组在此基础上联合关节内注射透明质酸治疗,观察和比较两组负重功能锻炼时间、并发症发生情况及治疗前、后膝关节功能、疼痛程度、生活质量等。结果:术后1、3、6个月观察组的膝关节Lysholm评分明显优于对照组(P<0.05)。术后6个月时,观察组患者评分优良率明显高于对照组患者(P<0.05)。比较治疗前VAS评分,两组情况相似,比较治疗后4、7、14d的VAS评分,对照组显著低于观察组(P<0.05)。两组治疗前ADL评分差异无统计学意义(P>0.05)。观察组治疗后4、7、14d的ADL评分明显优于对照组(P<0.05)。两组患者均未出现严重并发症。结论:关节镜下有限性清理术联合透明质酸钠注射液治疗膝骨性关节炎,对缓解疼痛症状、促进膝关节功能好转具有显著的效果,且能够改善患者的生活质量,具有临床借鉴意义。
Objective:To investigate the effect of limited debridement under arthroscopy combined with sodium hyaluronate injection on knee osteoarthritis and its influence on patients' quality of life.Methods:100 patients with knee osteoarthritis were randomly divided into observation group and control group,50 cases in each group.The patients in the control group were treated with limited debridement under arthroscope.The observation group was treated with hyaluronic acid injection on the basis of the control group.The time of weight-bearing exercise,complications,knee joint function,pain degree and quality of life before and after treatment were observed and compared between the two groups.Results:1 month,3 months and 6 months after operation,the Lysholm score of knee joint in the observation group was significantly better than than that in the control group(P<0.05).At 6 months after operation,the excellent and good rate of the observation group was significantly higher than that of the control group(P<0.05).The VAS score before treatment was similar between the two groups,at 4 days,7 days and 14 days after treatment,the VAS score was significantly lower in the control group than in the observation group(P<0.05).Before treatment,there was no significant difference in ADL score between the two groups(P>0.05).4 days,7 days and 14 days after treatment,the ADL score of the observation group was significantly better than that of the control group(P<0.05).There were no serious complications in both groups.Conclusion:Limited debridement under arthroscopy combined with sodium hyaluronate injection in the treatment of knee osteoarthritis has significant effect on relieving pain symptoms and improving knee function,and can improve the quality of life of patients with clinical reference.
Objective:To investigate the effect of limited debridement under arthroscopy combined with sodium hyaluronate injection on knee osteoarthritis and its influence on patients' quality of life.Methods:100 patients with knee osteoarthritis were randomly divided into observation group and control group,50 cases in each group.The patients in the control group were treated with limited debridement under arthroscope.The observation group was treated with hyaluronic acid injection on the basis of the control group.The time of weight-bearing exercise,complications,knee joint function,pain degree and quality of life before and after treatment were observed and compared between the two groups.Results:1 month,3 months and 6 months after operation,the Lysholm score of knee joint in the observation group was significantly better than than that in the control group(P<0.05).At 6 months after operation,the excellent and good rate of the observation group was significantly higher than that of the control group(P<0.05).The VAS score before treatment was similar between the two groups,at 4 days,7 days and 14 days after treatment,the VAS score was significantly lower in the control group than in the observation group(P<0.05).Before treatment,there was no significant difference in ADL score between the two groups(P>0.05).4 days,7 days and 14 days after treatment,the ADL score of the observation group was significantly better than that of the control group(P<0.05).There were no serious complications in both groups.Conclusion:Limited debridement under arthroscopy combined with sodium hyaluronate injection in the treatment of knee osteoarthritis has significant effect on relieving pain symptoms and improving knee function,and can improve the quality of life of patients with clinical reference.
引文
[1]薛庆云,王坤正,裴福兴,等.中国40岁以上人群原发性骨关节炎患病状况调查[J].中华骨科杂志,2015,35(12):1206-1212.
[2]熊志宏,熊翔.关节镜下有限清理术结合玻璃酸钠治疗高龄膝骨性关节炎[J].实用医学杂志,2012,28(18):3057-3059.
[3]强辉,崔雅清,冯敏.关节镜下前后联合松解治疗肘关节创伤性僵直疗效观察[J].陕西医学杂志,2017,46(11):1526-1528.
[4]Neo H,Ishimaru JI,Kurite K,et al.The effect of hyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep[J].J Oral Maxillofac Surg,1997,55(10):1114-1119.
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[7]周元,战爱玲,曾红春,等.超声评分法分级诊断膝骨性关节炎的初步研究[J].中国超声医学杂志,2018,34(6):556-560.
[8]黄伟毅,魏秋实,曾健英,等.独活寄生汤配合玻璃酸钠对膝骨关节炎患者生活质量的影响[J].广东医学,2014,35(15):2447-2450.
[9]郑吉元,安文博,姜劲挺.关节镜清理术治疗膝骨性关节炎临床研究进展[J].医学研究生学报,2015,28(7):776-779.
[10]郭景泉,罗毅,任尚立.关节镜下清理术联合玻璃酸钠及曲安奈德注射治疗膝骨关节炎疗效分析[J].河北北方学院学报:自然科学版,2015,31(6):86-88.
[11]蒋礼源,黄颂安.关节镜下清理术联合玻璃酸钠治疗膝关节骨性关节炎55例[J].广西医学,2012,34(9):1220-1221.
[12]Victor C,Alvin O,Fabio O,et al.Reply to the letter to the editor:compliance with the aaos guidelines for treatment of osteoarthritis of the knee:a survey of the american association of hip and knee surgeons[J].The Journal of the American Academy of Orthopaedic Surgeons,2018,26(16):e359-e360.
[13]黄坚汉,夏丽伟,蒙诗景,等.关节镜清理术联合不同方法治疗膝关节骨性关节炎的临床研究[J].微创医学,2017,12(2):179-182.
[14]Gomeli G,Karakaplan M,Gomeli CA,et al.Clinical effects of platelet-rich plasma and hyaluranic acid as an additional therapy for talar osteochondral lesions treated with mecrofrature surgery:a prospective randomized clinical trial[J].Foot Ankle Int,2015,36(8):891-900.
[15]徐昕,董耘,徐华,等.关节镜清理术联合透明质酸钠腔内注射治疗高龄膝关节骨性关节炎患者临床分析[J].中华全科医学,2016,14(9):1463-1465.
[16]Janet ES,Dustin RG,Carrie L,et al.The long-term impact of osteoarthritis following knee surgery in former college athletes[J].Journal of Sport Rehabilitation,2018,341:1-6.
[17]Reginster JY.Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis:results of a doubleblind randomised,placebo-controlled trial[J].Annals of the Rheumatic Diseases,2014,73(2):e8.
[18]王勇,曹平.关节镜术后联合玻璃酸钠腔对膝关节骨性关节炎患者的作用分析[J].成都医学院学报,2013,8(3):291-293.
[2]熊志宏,熊翔.关节镜下有限清理术结合玻璃酸钠治疗高龄膝骨性关节炎[J].实用医学杂志,2012,28(18):3057-3059.
[3]强辉,崔雅清,冯敏.关节镜下前后联合松解治疗肘关节创伤性僵直疗效观察[J].陕西医学杂志,2017,46(11):1526-1528.
[4]Neo H,Ishimaru JI,Kurite K,et al.The effect of hyaluronic acid on experimental temporomandibular joint osteoarthrosis in the sheep[J].J Oral Maxillofac Surg,1997,55(10):1114-1119.
[5]中华医学会骨科学分会.骨关节炎诊治指南(2007年版)[J].中国矫形外科杂志,2014,22(3):287-288.
[6]孙克宁.关节镜清理配合腔内注射玻璃酸钠治疗膝关节骨性关节炎疗效观察[J].济宁医学院学报,2015,38(6):403-405.
[7]周元,战爱玲,曾红春,等.超声评分法分级诊断膝骨性关节炎的初步研究[J].中国超声医学杂志,2018,34(6):556-560.
[8]黄伟毅,魏秋实,曾健英,等.独活寄生汤配合玻璃酸钠对膝骨关节炎患者生活质量的影响[J].广东医学,2014,35(15):2447-2450.
[9]郑吉元,安文博,姜劲挺.关节镜清理术治疗膝骨性关节炎临床研究进展[J].医学研究生学报,2015,28(7):776-779.
[10]郭景泉,罗毅,任尚立.关节镜下清理术联合玻璃酸钠及曲安奈德注射治疗膝骨关节炎疗效分析[J].河北北方学院学报:自然科学版,2015,31(6):86-88.
[11]蒋礼源,黄颂安.关节镜下清理术联合玻璃酸钠治疗膝关节骨性关节炎55例[J].广西医学,2012,34(9):1220-1221.
[12]Victor C,Alvin O,Fabio O,et al.Reply to the letter to the editor:compliance with the aaos guidelines for treatment of osteoarthritis of the knee:a survey of the american association of hip and knee surgeons[J].The Journal of the American Academy of Orthopaedic Surgeons,2018,26(16):e359-e360.
[13]黄坚汉,夏丽伟,蒙诗景,等.关节镜清理术联合不同方法治疗膝关节骨性关节炎的临床研究[J].微创医学,2017,12(2):179-182.
[14]Gomeli G,Karakaplan M,Gomeli CA,et al.Clinical effects of platelet-rich plasma and hyaluranic acid as an additional therapy for talar osteochondral lesions treated with mecrofrature surgery:a prospective randomized clinical trial[J].Foot Ankle Int,2015,36(8):891-900.
[15]徐昕,董耘,徐华,等.关节镜清理术联合透明质酸钠腔内注射治疗高龄膝关节骨性关节炎患者临床分析[J].中华全科医学,2016,14(9):1463-1465.
[16]Janet ES,Dustin RG,Carrie L,et al.The long-term impact of osteoarthritis following knee surgery in former college athletes[J].Journal of Sport Rehabilitation,2018,341:1-6.
[17]Reginster JY.Efficacy and safety of strontium ranelate in the treatment of knee osteoarthritis:results of a doubleblind randomised,placebo-controlled trial[J].Annals of the Rheumatic Diseases,2014,73(2):e8.
[18]王勇,曹平.关节镜术后联合玻璃酸钠腔对膝关节骨性关节炎患者的作用分析[J].成都医学院学报,2013,8(3):291-293.