药物联合应用在膝骨关节炎关节镜清理术后止痛的研究

Analgesic effect of intra-articular injection of sodium hyaluronate,dexamethasone and lidocaine after arthroscopic debridement for osteoarthritis of the knee.

目的观察联合应用玻璃酸钠+利多卡因+地塞米松在膝骨关节炎关节镜清理术后止痛作用。方法实验采用双盲随机分组,膝骨关节炎关节镜清理术病人50例,58膝,分为玻璃酸钠(2 ml)+2%利多卡因(2.5 ml)+地塞米松(2.5 mg)(A组,n=15),玻璃酸钠(2 ml)+生理盐水(5 ml)(B组,n=15),2%利多卡因(2.5 ml)+生理盐水(4.5ml)(C组,n=15),地塞米松(2.5 mg)+生理盐水(4.5 ml)(D组,n=13),每例患者于术后关节腔注射,分别在给药后8 h、24 h、72 h、一周时,在病人双足站立膝关节伸展状态下进行视觉模拟评分(VAS),结果用q检验。结果术后8h,A组和C组的止痛效果好于B组和D组(P<0.05)但术后72 h和一周时B组和A组的止痛效果明显好于C组和D组(P<0.05)。结论膝骨关节炎关节镜清理术后联合应用玻璃酸钠+利多卡因+地塞米松在早期止痛和持续镇痛方面有较为满意的临床效果。

Objective To investigate the analgesic effect of intra - aticular injection of sodium hyaluronate （ SH ）, dexamethasone （DXM） and lidocaine （LID） following the arthroscopic debrideinent for osteoarthritis of the knee. Methods In this prospective double - blind study, 50 patients （58 knees） with osteoarthritis of the knee were randomly assigned to receive SH（2 ml） ＋ LIN（2.5 ml） ＋ DXM（2,5 mg） （group A, n =15）, SH （2 ml） ＋NS（5ml） （groupB, n =15）, LIN （2.5 ml） ＋ NS（4.5ml） （groupC, n =15） or DXM （2. 5 mg） ＋ NS（4.5ml） （ group D n = 13 ） at the end of arthroscopic surgery . The analgesic efiqcaey was tested by a visual analog scale （VAS） at 8, 24, 72 hours and 1 week after operation. Results The analgesic efficacy in group A and C was significantly better than that in B group and D group 8 hours after operation （ P 〈 0.05 ）, But the analgesic efficacy in group A and B was significantly better than that in C group and D group 72 hours and 1 week after operation （ P 〈 0.05 ）. Conclusion lntra - aticular injection of SH, LIN and DXM after arthroscopic debrideinent for osteoarthritis can effectively relieve pain in the knee joint.