膝關節鏡治療癥狀性膝關節骨關節炎的臨床效果

張澤

[摘要]目的 探討膝關節鏡治療癥狀性膝關節骨關節炎的臨床效果。方法 選取2016年1月～2017年7月我院收治的80例癥狀性膝骨性骨性關節炎患者作為研究對象，按照隨機數字法分為兩組（對照組與觀察組），每組各40例。對照組患者實施玻璃酸鈉注射液膝關節腔內注射，觀察組患者在對照組基礎上，實施膝關節鏡下關節清理術，比較治療過程中患者的膝關節疼痛VAS評分，治療后患者膝關節ROM角度變化和膝關節Lysholm功能評分，統計兩組患者的臨床效果。結果 治療后1周和治療后4周，觀察組患者的膝關節疼痛VAS評分低于對照組（P<0.05）；治療后觀察組患者的膝關節ROM角度大于對照組（P<0.05），膝關節Lysholm功能得分高于對照組（P<0.05）；觀察組患者的治療優良率為95.0%，顯著高于對照組的75.0%，差異均有統計學意義（P<0.05）。結論 針對存在明顯臨床癥狀的膝關節骨性關節炎患者，以膝關節鏡聯合玻璃酸鈉治療，可有效緩解患者疼痛，改善膝關節功能，提高臨床治療效果。

[關鍵詞]膝關節鏡；膝關節骨關節炎；疼痛；膝關節功能

[中圖分類號] R394.2 [文獻標識碼] A [文章編號] 1674-4721（2018）2（c）-0050-03

[Abstract]Objective To investigate the clinical efficacy of knee arthroscopy in the treatment of symptomatic knee osteoarthritis.Methods 80 cases with symptomatic knee osteoarthritis treated in our hospital from January 2016 to July 2017 were selected as the subjects，and divided into the two groups （control group and observation group） by random table method，40 cases in each group.The control group were treated with intraperitoneal injection of sodium hyaluronate injection in the knee joint.The observation group was treated with knee arthroplasty under the control group.The VAS score of the knee joint pain during the treatment were compared，the joint ROM angle changes，knee Lysholm functional score and the overall clinical treatment between the two groups were compared.Results The VAS score of knee joint pain in the observation group was lower than the control group at 1 week and 4 weeks after treatment（P<0.05）.The ROM angle in the observation group was higher than that in the control group （P<0.05）.The Lysholm function score in the observation group was higher than that in the control group （P<0.05）.The excellent rate of overall treatment in the observation group was 95.0%，which was significantly higher than 75.0% of the control group，the difference was statistically significant （P<0.05）.Conclusion Knee arthritis combined with sodium hyaluronate can effectively relieve pain in patients with knee joint，improve knee function，and improve the clinical effect in the treatment of osteoarthritis of knee joint with obvious clinical symptoms.

[Key words]Knee arthroscopy；Knee osteoarthritis；Pain；Knee joint function

膝骨性關節炎是臨床最為常見的膝退行性關節疾病，好發于中老年人群，尤以絕經后女性患者居多[1]，病理生理改變以關節軟骨退行性變化為主要病因[2]。研究顯示，年齡為60歲以上的老年女性，本病發生率在50%左右[3]，主要以存在早期的關節影像學改變為主，但多數患者無明顯臨床癥狀，改變以分子階段為主，針對此類患者多未能引起足夠的臨床重視。目前對于本病的治療，建議膝關節腔內注射玻璃酸鈉，補充外源性的關節液進而延緩關節軟骨的退行性變化，稀釋關節腔內炎癥介質的水平，改善關節軟骨的潤滑情況，達到改善關節腔內滑液的性質[4]，提高臨床治療效果的目的。但單純應用玻璃酸鈉注射液關節腔內給藥，雖可于短期內針對患者關節癥狀起到一定的改善作用，但治療時間長、費用高，同時反復膝關節腔有創穿刺[5]，還有可能導致膝關節腔感染，存在一定的醫療風險[6]。目前臨床急需一種有效的治療方法，用于提高膝關節骨性關節炎患者的臨床治療效果，減少并發癥。關節鏡近年來用于治療膝關節相關疾病的效果十分顯著，具有微創、效果可靠等優點，本研究旨在探討膝關節鏡治療癥狀性膝關節骨關節炎的臨床效果，現報道如下。