| 涂少龙.关节镜清理术联合药物注射治疗膝关节骨性关节炎的疗效分析.骨科,2015,6(1): 28-31. |
| 关节镜清理术联合药物注射治疗膝关节骨性关节炎的疗效分析 |
| Effect of sequential arthroscopic debridement and intra-articular injection on knee osteoarthritis |
| 投稿时间：2014-07-24 |
| DOI：10.3969/j.issn.1674-8573.2015.01.008 |
| 中文关键词: 骨关节炎，膝 关节镜检查 注射，关节内 治疗结果 |
| 英文关键词: Osteoarthritis, knee Arthroscopy Injections, intra-articular Treatment outcome |
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| 中文摘要: |
| 目的 分析关节镜清理术联合玻璃酸钠注射治疗膝关节骨性关节炎（knee osteoarthritis，KOA）的效果，并观察复方倍他米松和罗哌卡因辅助治疗KOA的镇痛及改善关节功能的效果。方法 收集2011年6月至2013年5月我院收治的KOA患者129例，依照标准筛选出90例纳入本研究，随机分为三组，每组30例，关节镜清理组单行关节镜清理术，联合玻璃酸钠组行关节镜清理术联合注射玻璃酸钠，联合多种药物组行关节镜清理术联合注射玻璃酸钠、复方倍他米松和罗哌卡因。应用疼痛视觉模拟评分法（visual analogue scale, VAS）以及各种定性评定标准评定治疗效果。结果 在术后4个时间点记录所有病例的VAS评分，比较各组的VAS评分，差异均有统计学意义（均P＜0.05），其中联合多种药物组评分最低，其次是联合玻璃酸钠组，关节镜清理组最高。术后6个月，关节镜清理组的治疗优良率为60.0%，有效率为76.7%；联合玻璃酸钠组的治疗优良率为76.7%，有效率为90.0%；联合多种药物组的治疗优良率为83.3%，有效率为93.3%。术后6个月，各组间两两比较治疗有效率和膝关节HSS评分，关节镜清理组与联合玻璃酸钠组、联合玻璃酸钠组与联合多种药物组比较，差异均有统计学意义（均P＜0.05）；联合玻璃酸钠组与联合多种药物组比较，差异无统计学意义（P＞0.05）。结论 关节镜清理术联合注射玻璃酸钠（或加用复方倍他米松和罗哌卡因）治疗KOA效果显著，优于单独运用膝关节镜清理术治疗早期骨关节炎。 |
| 英文摘要: |
| Objective To study the effect of arthroscopic debridement combined with intra-articular injection of sodium hyaluronate on knee osteoarthritis (KOA), and observe the efficacy of compound betamethasone and ropivacaine for analgesic and improving the function of joint in the adjuvant treatment of KOA. Methods 129 patients with KOA were collected during Jun. 2011 to May 2013, of which 90 patients were enrolled in this study according to the standard, and they were randomly divided into 3 groups (n=30 each). Arthroscopy group was given single arthroscopic debridement, sodium hyaluronate-treated group was given arthroscopic debridement combined with injection of sodium hyaluronate, and experimental group given arthroscopic debridement combined with injection of sodium hyaluronate, compound betamethasone and ropivacaine. The pain visual analog scale (VAS) and a variety of qualitative evaluation standard were used to evaluate the curative effect.
Results The VAS scores of all cases were recorded at 4 postoperative time points. The VAS scores were highest in experimental group, followed by sodium hyaluronate-treated group and arthroscopy group in turn, with the differences being statistically significant among the groups (P<0.05 for all). At 6th month after operation, the excellent and good rate, and effective rate were 60% and 76.7% in arthroscopy group; 76.7% and 90% in sodium hyaluronate-treated group, and 83.3% and 93.3% in experimental group, respectively. At 6th month after surgery, there was significant difference in effective rate and the knee joint HSS score between the arthroscopic group and sodium hyaluronate-treated group or between sodium hyaluronate-treated group and experimental group (P<0.05 for all), but no significant differences were found between the sodium hyaluronate-treated group and experimental group (P>0.05). Conclusion Arthroscopic debridement combined with sodium hyaluronate, diprospan and ropivacaine can get excellent effectiveness. The application of the arthroscopic debridement alone should not be recommended. |
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