细针钻孔减压术联合玻璃酸钠关节腔注射治疗膝骨关节炎67例临床观察(1)
【摘 要】目的：观察细针钻孔减压术联合玻璃酸钠关节腔注射治疗膝骨关节炎患者的疗效与近、中期随访结果。方法：将134例膝骨关节炎患者按照不同治疗方案分为治疗组和对照组，每组67例。对照组给予玻璃酸钠关节腔注射治疗，治疗组采用细针钻孔减压术联合玻璃酸钠关节腔注射治疗。比较2组临床疗效以及治疗前、末次随访时膝关节疼痛视觉模拟评分法(VAS)评分、膝关节功能量表(Lysholm)评分、生活质量评分(SF-36)。结果：治疗组显效40例，有效21例，无效6例，总有效率为91.04%；对照组显效27例，有效20例，无效20例，总有效率为70.15%。2组比较，差异有统计学意义(P < 0.05)。末次随访时，2组VAS评分、Lysholm评分、SF-36评分较治疗前均有改善(P < 0.05)，且治疗组优于对照组(P < 0.05)。结论：细针钻孔减压术联合玻璃酸钠关节腔注射治疗膝骨关节炎能显著减轻患者疼痛程度，改善膝关节功能，提高生活质量，近、中期疗效显著。
【关键词】 骨关节炎，膝；细针钻孔减压术；玻璃酸钠；关节腔注射；膝关节功能评分
【ABSTRACT】Objective：To observe the curative effect of fine needle drilling decompression combined with sodium hyaluronate in the treatment of knee osteoarthritis as well as short and mid-term follow-up results.Methods：One hundred and thirty-four cases of knee osteoarthritis，according to the different treatment plan，were divided into a treatment group and a control group，sixty-seven cases in each group.The control group was treated with intra-articular injection of sodium hyaluronate，while the treatment group was treated with fine needle drilling decompression combined with sodium hyaluronate.Both groups were compared on the aspects of curative effect，VAS scores before treatment and last follow-up，Lysholm score and SF-36 score.Results：In the treatment group，40 cases were markedly effective，21 cases were effective，6 cases were ineffective，and the total effective rate was 91.04%；while in the control group，27 cases were markedly effective，20 cases were effective，20 cases were ineffective，and the total effective rate was 70.15%.The difference between the two groups was statistically significant(P < 0.05).At the last follow-up，VAS score，Lysholm score and SF-36 score of the two groups were improved(P < 0.05)compared with those before treatment，and the treatment group was better than the control group(P < 0.05).Conclusion：Fine needle drilling decompression combined with sodium hyaluronate in the treatment of knee osteoarthritis can significantly relieve pain and improve knee function and quality of patients’ lives，having short and mid-term curative effects.
【Keywords】 osteoarthritis，knee；fine needle drilling decompression；sodium hyaluronate；articular injection；knee joint function score
膝骨關节炎(knee osteoarthritis，KOA)为临床多发慢性关节病，多发于中老年人群，临床表现为关节肿大、僵硬、疼痛及活动度丧失，严重损害患者膝关节功能，甚至可导致残疾，对其生命健康与生活质量造成极大影响[1]。目前，临床治疗KOA的方法主要有手术治疗与药物治疗两种，玻璃酸钠是关节滑液与软骨基质重要成分，具有维持软骨黏弹性、保护软骨、润滑关节等作用，被广泛运用于骨关节病的治疗中[2]；同时，细针钻孔减压术为本病常用术式之一，可迅速降低股骨、胫骨骨内压，改善膝关节内外血流动力学，加速致痛物质吸收，具有良好的止痛效果。但目前关于联合运用细针钻孔减压术与玻璃酸钠关节腔注射治疗KOA的研究报道较少。本研究选择134例KOA患者，分组观察细针钻孔减压术联合玻璃酸钠关节腔注射治疗的近、中期随访效果，现总结报告如下。, http://www.100md.com(宋全明)
【关键词】 骨关节炎，膝；细针钻孔减压术；玻璃酸钠；关节腔注射；膝关节功能评分
【ABSTRACT】Objective：To observe the curative effect of fine needle drilling decompression combined with sodium hyaluronate in the treatment of knee osteoarthritis as well as short and mid-term follow-up results.Methods：One hundred and thirty-four cases of knee osteoarthritis，according to the different treatment plan，were divided into a treatment group and a control group，sixty-seven cases in each group.The control group was treated with intra-articular injection of sodium hyaluronate，while the treatment group was treated with fine needle drilling decompression combined with sodium hyaluronate.Both groups were compared on the aspects of curative effect，VAS scores before treatment and last follow-up，Lysholm score and SF-36 score.Results：In the treatment group，40 cases were markedly effective，21 cases were effective，6 cases were ineffective，and the total effective rate was 91.04%；while in the control group，27 cases were markedly effective，20 cases were effective，20 cases were ineffective，and the total effective rate was 70.15%.The difference between the two groups was statistically significant(P < 0.05).At the last follow-up，VAS score，Lysholm score and SF-36 score of the two groups were improved(P < 0.05)compared with those before treatment，and the treatment group was better than the control group(P < 0.05).Conclusion：Fine needle drilling decompression combined with sodium hyaluronate in the treatment of knee osteoarthritis can significantly relieve pain and improve knee function and quality of patients’ lives，having short and mid-term curative effects.
【Keywords】 osteoarthritis，knee；fine needle drilling decompression；sodium hyaluronate；articular injection；knee joint function score
膝骨關节炎(knee osteoarthritis，KOA)为临床多发慢性关节病，多发于中老年人群，临床表现为关节肿大、僵硬、疼痛及活动度丧失，严重损害患者膝关节功能，甚至可导致残疾，对其生命健康与生活质量造成极大影响[1]。目前，临床治疗KOA的方法主要有手术治疗与药物治疗两种，玻璃酸钠是关节滑液与软骨基质重要成分，具有维持软骨黏弹性、保护软骨、润滑关节等作用，被广泛运用于骨关节病的治疗中[2]；同时，细针钻孔减压术为本病常用术式之一，可迅速降低股骨、胫骨骨内压，改善膝关节内外血流动力学，加速致痛物质吸收，具有良好的止痛效果。但目前关于联合运用细针钻孔减压术与玻璃酸钠关节腔注射治疗KOA的研究报道较少。本研究选择134例KOA患者，分组观察细针钻孔减压术联合玻璃酸钠关节腔注射治疗的近、中期随访效果，现总结报告如下。, http://www.100md.com(宋全明)