人工全膝关节置换术治疗类风湿性关节炎患者的临床疗效
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摘要
目的探讨人工全膝关节置换术治疗类风湿性关节炎患者的临床疗效及术后膝关节功能的影响。方法本文选择我院2012年4月～2017年3月收治的73例患者随机分为观察组(n=37)和对照组(n=36)。两组均进行常规基础药物治疗,对照组给予玻璃酸钠膝关节腔局部注射治疗,观察组给予人工全膝关节置换术治疗。比较两组ROM评分、HSS评分及SF-36评分。结果治疗后,两组ROM评分明显高于治疗前,差异有统计学意义(t=-15.308,P=0.000;t=2.205,P=0.032);而且,观察组ROM评分明显高于对照组,差异有统计学意义(t=2.205,P=0.032)。两组HSS评分较治疗前均显著升高,差异均有统计学意义(P<0.05);而且,观察组HSS评分明显高于对照组,差异有统计学意义(P<0.05)。两组SF-36评分与治疗前比较均显著升高,差异有统计学意义(P<0.05);观察组SF-36评分显著高于对照组,差异有统计学意义(P<0.05);但观察组GH评分与对照组比较无明显差异,差异无统计学意义(P>0.05)。结论 TKA治疗RA临床疗效显著,可有效根除患者疼痛症状,改善患者膝关节功能,提高患者生活质量,值得推广应用。
Objective To investigate the clinical efficacy of artificial total knee arthroplasty in the treatment of patients with rheumatoid arthritis and its influence on postoperative knee function. Methods 73 patients admitted in our hospital from April 2012 to March 2017 were randomLy divided into observation group(n=37) and control group(n=36). The two groups were treated with conventional basic drugs. The control group was given knee joint cavity local injection of sodium hyaluronate, and the observation group was treated with artificial total knee arthroplasty. The ROM score, HSS score and SF-36 score of the two groups were observed and compared. Results The ROM scores of the two groups after treatment were significantly higher than those before treatment, and the difference was statistically significant(t=-15.308, P=0.000; t=2.205, P=0.032). Moreover, the ROM score of the observation group was significantly higher than that of the control group, and the difference was statistically significant(t=2.205, P=0.032). The HSS scores of the two groups after treatment were significantly higher than those before treatment(P<0.05). Moreover, the HSS scores of the observation group were significantly higher than the control group, and the difference was statistically significant(P<0.05).The scores of SF-36 in both groups were significantly higher than those before treatment, and the difference was significant(P<0.05). Moreover, the score of SF-36 in the observation group was significantly higher than that in the control group(P<0.05). However, there was no significant difference in the GH score between the observation group and the control group(P>0.05). Conclusion TKA has a significant clinical effect in the treatment of RA, which can effectively eradicate the pain symptoms of patients, improve the knee joint function and improve the quality of life of patients. It is worthy of popularization and application.
Objective To investigate the clinical efficacy of artificial total knee arthroplasty in the treatment of patients with rheumatoid arthritis and its influence on postoperative knee function. Methods 73 patients admitted in our hospital from April 2012 to March 2017 were randomLy divided into observation group(n=37) and control group(n=36). The two groups were treated with conventional basic drugs. The control group was given knee joint cavity local injection of sodium hyaluronate, and the observation group was treated with artificial total knee arthroplasty. The ROM score, HSS score and SF-36 score of the two groups were observed and compared. Results The ROM scores of the two groups after treatment were significantly higher than those before treatment, and the difference was statistically significant(t=-15.308, P=0.000; t=2.205, P=0.032). Moreover, the ROM score of the observation group was significantly higher than that of the control group, and the difference was statistically significant(t=2.205, P=0.032). The HSS scores of the two groups after treatment were significantly higher than those before treatment(P<0.05). Moreover, the HSS scores of the observation group were significantly higher than the control group, and the difference was statistically significant(P<0.05).The scores of SF-36 in both groups were significantly higher than those before treatment, and the difference was significant(P<0.05). Moreover, the score of SF-36 in the observation group was significantly higher than that in the control group(P<0.05). However, there was no significant difference in the GH score between the observation group and the control group(P>0.05). Conclusion TKA has a significant clinical effect in the treatment of RA, which can effectively eradicate the pain symptoms of patients, improve the knee joint function and improve the quality of life of patients. It is worthy of popularization and application.
引文
[1]穆少丽,张娟.多媒体强化健康宣教对类风湿关节炎患者预后的影响[J].山西医药杂志,2018,47(2):208-210.
[2]宋健,于丽,王文华,等.类风湿性关节炎患者ACCP抗体联合风湿四项RF、ESR、CRP、ASO检测的临床价值[J]中国地方病防治杂志,2016,31(1):77-78.
[3]王启增.全膝关节置换术治疗中重度膝关节骨性关节炎的临床疗效探讨[J].中国继续医学教育,2016,8(22):103-104.
[4]吴训华.CT运动成像评判类风湿性关节炎患者关节运动能力并探究其与类风湿因子的相关性[J].中国CT和MRI杂志,2016,14(6):118-120.
[5]刘益鸣,张挺杰,李君,等.发散式体外冲击波有效缓解类风湿关节炎患者的关节疼痛[J].中国疼痛医学杂志,2016,22(3):228-231.
[6]覃小东,李朝健,符俏.人工膝关节常用假体材料及其生物相容性[J].中国组织工程研究,2012,16(12):2257-2260.
[7]庞涛,郭燕芬,孙锋,等.人工全膝关节置换术治疗类风湿性关节炎22例疗效观察[J].中国骨与关节损伤杂志,2013,28(10):961-962.
[8]林冰.一九八七年美国风湿病学会对类风湿性关节炎诊断的修订标准[J].中国康复医学杂志,1989,4(1):42
[9]Shupik A,Biafoszewski D.A comparative analysis of the clinical utility of the Staffelstein-score and the hospital for special surgery knee score(HSS)in monitoring physiotherapy of total knee replacement patients-preliminary study[J].Ortop Traumatol Rehabil,2009,11(1):37-45.
[10]李春波,何燕玲.健康状况调查问卷SF-36的介绍[J]国外医学(精神病学分册),2002,29(2):116-119.
[11]Eid AS,Nassar WA,Fayyad TA.Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee[J].Int Orthop,2016,40(11):2289-2293.
[12]王徐龙,李旭伟,龚铁军,等.膝表面置换术在类风湿性膝关节炎和骨性膝关节炎的应用和比较[J].中国骨与关节损伤杂志,2016,31(6):595-598.
[13]饶莉,沈春瑾,石哲群,等.中西医结合治疗类风湿性关节炎的临床研究[J].中华中医药杂志,2016,35(2):546-548.
[14]丁盛,张建坡,徐岳林,等.膝关节置换术治疗老年类风湿性膝关节炎疗效分析[J].中国医学前沿杂志(电子版),2018,10(4):98-101.
[15]杰恩斯·达尼牙尔,艾克拜尔·尤努斯,陈江涛,等.股骨干骨折内固定术后骨不连外科治疗[J].中华实用诊断与治疗杂志,2015,29(2):152-154.
[16]高明堂,陈健,潘连印,等.人工全膝关节置换术治疗僵直膝30例效果观察[J].山东医药,2013,53(11):72-73.
[17]Wang K,Ni S,Li Z,et al.The effects of tourniquet use in total knee arthroplasty:A randomized,controlled trial[J].Knee Surg Sports Traumatol Arthrosc,2017,25(9):2849-2857.
[18]金艳南.双侧人工全膝关节置换术对类风湿性关节炎患者术后膝关节功能及日常生活能力的影响[J].河南外科学杂志,2018,24(5):66-68.
[19]陈建文,卢敏,王勇.人工全膝关节置换术治疗膝关节类风湿性关节炎短期疗效随访[J].中国现代药物应用,2018,12(13):76-77.
[20]Al-Muzafar HM,Amin KA.Efficacy of functional foods mixture in improving hypercholesterolemia,inflammatory and endothelial dysfunction biomarkers-induced by high cholesterol diet[J].Lipids Health Dis,2017,16(1):194.
[21]Singh JA,Inacio MC,Namba RS,et al.Rheumatoid arthritis is associated with higher ninety-day hospital readmission rates compared to osteoarthritis after hip or knee arthroplasty:A cohort study[J].Arthritis Care Res(Hoboken),2015,67(5):718-724.
[22]贾科江,杨朝垒,马国涛,等.人工全膝关节置换术治疗类风湿性关节炎的疗效分析[J].临床骨科杂志,2014,17(6):677-679.
[23]Boettner F,Renner L,Arana Narbarte D,et al.Total knee arthroplasty for valgus osteoarthritis:The results of a standardized soft-tissue release technique[J].Knee Surg Sports Traumatol Arthrosc,2016,24(8):2525-2531.
[24]徐小会,王华溢,段永宏,等.人工全膝关节置换术治疗膝关节类风湿性关节炎中短期疗效随访[J].中华关节外科杂志(电子版),2014,(3):31-35.
[25]郭建斌,闻振坤,李坤,等.全膝关节置换术治疗骨关节炎及类风湿性关节炎效果比较[J].中华实用诊断与治疗杂志,2018,32(3):258-261.
[2]宋健,于丽,王文华,等.类风湿性关节炎患者ACCP抗体联合风湿四项RF、ESR、CRP、ASO检测的临床价值[J]中国地方病防治杂志,2016,31(1):77-78.
[3]王启增.全膝关节置换术治疗中重度膝关节骨性关节炎的临床疗效探讨[J].中国继续医学教育,2016,8(22):103-104.
[4]吴训华.CT运动成像评判类风湿性关节炎患者关节运动能力并探究其与类风湿因子的相关性[J].中国CT和MRI杂志,2016,14(6):118-120.
[5]刘益鸣,张挺杰,李君,等.发散式体外冲击波有效缓解类风湿关节炎患者的关节疼痛[J].中国疼痛医学杂志,2016,22(3):228-231.
[6]覃小东,李朝健,符俏.人工膝关节常用假体材料及其生物相容性[J].中国组织工程研究,2012,16(12):2257-2260.
[7]庞涛,郭燕芬,孙锋,等.人工全膝关节置换术治疗类风湿性关节炎22例疗效观察[J].中国骨与关节损伤杂志,2013,28(10):961-962.
[8]林冰.一九八七年美国风湿病学会对类风湿性关节炎诊断的修订标准[J].中国康复医学杂志,1989,4(1):42
[9]Shupik A,Biafoszewski D.A comparative analysis of the clinical utility of the Staffelstein-score and the hospital for special surgery knee score(HSS)in monitoring physiotherapy of total knee replacement patients-preliminary study[J].Ortop Traumatol Rehabil,2009,11(1):37-45.
[10]李春波,何燕玲.健康状况调查问卷SF-36的介绍[J]国外医学(精神病学分册),2002,29(2):116-119.
[11]Eid AS,Nassar WA,Fayyad TA.Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee[J].Int Orthop,2016,40(11):2289-2293.
[12]王徐龙,李旭伟,龚铁军,等.膝表面置换术在类风湿性膝关节炎和骨性膝关节炎的应用和比较[J].中国骨与关节损伤杂志,2016,31(6):595-598.
[13]饶莉,沈春瑾,石哲群,等.中西医结合治疗类风湿性关节炎的临床研究[J].中华中医药杂志,2016,35(2):546-548.
[14]丁盛,张建坡,徐岳林,等.膝关节置换术治疗老年类风湿性膝关节炎疗效分析[J].中国医学前沿杂志(电子版),2018,10(4):98-101.
[15]杰恩斯·达尼牙尔,艾克拜尔·尤努斯,陈江涛,等.股骨干骨折内固定术后骨不连外科治疗[J].中华实用诊断与治疗杂志,2015,29(2):152-154.
[16]高明堂,陈健,潘连印,等.人工全膝关节置换术治疗僵直膝30例效果观察[J].山东医药,2013,53(11):72-73.
[17]Wang K,Ni S,Li Z,et al.The effects of tourniquet use in total knee arthroplasty:A randomized,controlled trial[J].Knee Surg Sports Traumatol Arthrosc,2017,25(9):2849-2857.
[18]金艳南.双侧人工全膝关节置换术对类风湿性关节炎患者术后膝关节功能及日常生活能力的影响[J].河南外科学杂志,2018,24(5):66-68.
[19]陈建文,卢敏,王勇.人工全膝关节置换术治疗膝关节类风湿性关节炎短期疗效随访[J].中国现代药物应用,2018,12(13):76-77.
[20]Al-Muzafar HM,Amin KA.Efficacy of functional foods mixture in improving hypercholesterolemia,inflammatory and endothelial dysfunction biomarkers-induced by high cholesterol diet[J].Lipids Health Dis,2017,16(1):194.
[21]Singh JA,Inacio MC,Namba RS,et al.Rheumatoid arthritis is associated with higher ninety-day hospital readmission rates compared to osteoarthritis after hip or knee arthroplasty:A cohort study[J].Arthritis Care Res(Hoboken),2015,67(5):718-724.
[22]贾科江,杨朝垒,马国涛,等.人工全膝关节置换术治疗类风湿性关节炎的疗效分析[J].临床骨科杂志,2014,17(6):677-679.
[23]Boettner F,Renner L,Arana Narbarte D,et al.Total knee arthroplasty for valgus osteoarthritis:The results of a standardized soft-tissue release technique[J].Knee Surg Sports Traumatol Arthrosc,2016,24(8):2525-2531.
[24]徐小会,王华溢,段永宏,等.人工全膝关节置换术治疗膝关节类风湿性关节炎中短期疗效随访[J].中华关节外科杂志(电子版),2014,(3):31-35.
[25]郭建斌,闻振坤,李坤,等.全膝关节置换术治疗骨关节炎及类风湿性关节炎效果比较[J].中华实用诊断与治疗杂志,2018,32(3):258-261.