关节镜术后联合罗哌卡因和复方倍他米松治疗膝关节骨性关节炎的疗效观察

Effects of intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement for knee osteoarthritis

目的观察膝关节镜清理术后联合罗哌卡因和复方倍他米松关节腔注射治疗膝关节骨性关节炎的疗效。方法因膝关节骨性关节炎行关节镜清理手术的164例患者随机分为3组：联合治疗组62例，复方倍他米松组54例和对照组48例。采用Lequesne的膝关节骨性关节炎评分标准，分别于术前、术后1周、6周、12周进行疗效评估。结果164例患者均获有效随访，术前、术后1、6、12周疗效评分联合治疗组分别为（21．3±4．8）分、（12．3±4．3）分、（9．2土6．3）分、（8．2±5．5）分；复方倍他米松组分别为（21．7±5．1）分、（14．7±5．8）分、（12．4±5．8）分、（9．1±4．8）分；对照组分别为（20．9±4．2）分、（15．2±_5．5）分、（15．8±6．3）分、（14．4±6．9）分。联合治疗组、复方倍他米松组及对照组各组内治疗前后疗效比较，差异有统计学意义（均P〈0．05），组间比较表明术后1周、6周、12周，联合治疗组及复方倍他米松组疗效较对照组有统计学意义（P〈0．05），术后1周、6周，联合治疗组疗效对比复方倍他米松组差异有统计学意义（P〈0．05），而术后12周差异无统计学意义（P〉O．05）。结论膝骨性关节炎在关节镜清理术后，关节腔内注射罗哌卡因及复方倍他米松，可有效缓解术后疼痛，促进功能恢复。

Objective To investigate the effects of intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement for knee osteoarthritis. Methods A total of 164 patients with knee osteoarthritis after arthroscopic debridement were randomly divided into three groups： combination group （n= 62） treated by 2 ml sodium hyaluronate and 0.75 % ropivacaine of 5 ml plus 1 ml compound betamethasone, compound betamethasone group （n= 54） by 2 ml sodium hyaluronate and 1 ml compound betamethasone, control group （n= 48） by simply sodium hyaluronate. The Lequesne Index was used to evaluate the clinical effects before and 1 week,6 weeks and 12 weeks after operation. All patients received at least 12 weeks follow-up Results According to Lequesne Index score criteria, a significant decrease was found in all groups before versus after operation（P〈 0.05）. The clinical effects in combination group and compound betamethasone group were more improved as compared with control group at 1,6 and ]2 weeks after operation （P〈0.05）. The effect in combination group was better than compound betamethasone group at 1 and 6 weeks after operation, but not at 12 weeks （P〈0.05）. Conclusions The intra-articular injection of ropivacaine plus compound betamethasone after arthroscopic debridement is a good method for relieving pain and improving the knee function.