关节镜治疗膝关节骨性关节炎化脓性感染的临床分析

Clinical curative effect analysis of arthroscopy for knee osteoarthritis complicated with purulent infection

目的探讨关节镜对膝关节骨性关节炎并发化脓感染的临床治疗效果，为临床资料提供参考依据。方法将医院2012年2—12月关节外科住院的57例膝关节骨性关节炎并发化脓感染患者随机分为两组，治疗组28例采用关节镜下清理加术后持续灌洗治疗；对照组29例采用传统的开放手术清理加术后持续灌洗治疗；观察术后的清理效果、切口感染率、平均住院日、关节活动度及关节功能评价，并随访6～12个月后的治疗效果。结果治疗组患者的清理效果令人满意为100．00％，切口感染率为3．57％，平均住院14d，术后2周的屈膝活动度〉120°的有25例占89．29％，与对照组相比，其差异有统计学意义（P〈0．05）。结论关节镜对膝关节骨性关节炎并发化脓感染的治疗具有创伤小、清创彻底的特点，对术后恢复与炎症的缓解和消除有很好的疗效，值得推广。

OBJECTIVE To evaluate the clinical therapeutic effect of arthroscopy on knee joint osteoarthritis complicated with purulent infections for reference for clinical data. METHODS Totally 57 inpatients with knee osteoarthritis complicated festering infections in the department of joint surgery from Feb. 2012 to Dec. 2012 were randomly divided into two groups. The treatment group received cleaning under arthroscopy and continuous lavage treatment. The control graup received traditional clearing after open surgery and continuous lavage therapy after surgery. The cleaning effect, the postoperative incision infection rate, average hospital stays, joint motion and joint function assessment were observed, and patients were followed up for 6～ 12 months for concurrent conditions. RESULTS Cleaning efficiency was satisfactory （100%） in the treatment group, with the incision infection rate of 3.57%, the average hospitalization of 14 days, and there were 25 cases （89.29%） with knee mobility 120° after 2 weeks; compared with the control group, the differences were significant （P〈0.05）. CONCLUSION Arthroscopy for purulent infection concurrent with knee joint osteoarthritis is worthy of promotion, as it has characteristics of small trauma and complete debridement, which has a good curative benefit for the postoperative recovery and inflammation relief and resolution.