玻璃酸钠治疗髌骨软骨软化症

Sodium hyaluronate for treatment of chondromalacia patella syndrome

背景:玻璃酸钠本身特殊的理化性质决定了其非常重要的生理作用,如构成细胞基质、润滑关节、促进组织损伤修复等。目的:观察玻璃酸钠注射治疗不同病程髌骨软化症的疗效。方法:76例髌骨软化症患者关节腔内注射玻璃酸钠2 m L(以髌骨内侧缘为进针点,每周1次,5周为1个疗程),根据病程分两组,病程<3个月32例,病程>3个月44例,随访1年观察远期疗效。结果与结论:随访1年发现病程<3个月组的优良率达94%,远期疗效优于病程>3个月组(优良率73%)。治疗期间无明显毒副作用,其中有5例注射后疼痛加重,可能与髌下积液未抽尽和早期穿刺技术不熟练有关,休息后一两天均得到缓解,未发生感染。结果可见玻璃酸钠是治疗髌骨软化症的有效药物,早期治疗及合理的进针点是保证疗效的关键。

BACKGROUND： According to the special physical and chemical properties, the sodium hyaluronate plays a very important physiological role, such as constructing the cellular matrix, lubricating the joints, and promoting the＇ repair of tissue damage. OBJECTIVE： To observe the therapeutic effect of sodium hyaluronate on chondromalacia patellar syndrome with different disease courses. METHODS： A total of 76 patients with chondromalacia patellar syndrome received intra-articular injection of 2 mL sodium hyalurenate once a week for 5 consecutive weeks as a course, with the entry point on the medial margin of the patella. All the patients were divided into two groups according to the disease course： ~ 3 months group （n=32） and 〉 3 months group （n=44）. One-year follow-up was done to summarize the therapeutic effect. RESULTS AND CONCLUSION： After follow-up for I year, the excellent and good rate was 94% in the 〈 3 months group, which was superior to the 〉 3 months group （73%）. There was no side effect and infection during the treatment. Five patients appeared to have pain worsened after treatment, which may be caused as follows： Patellar effusion was removed incompletely and early puncture was unskilled. The pain was relieved within 1-2 days after the break. Results showed that the sodium hyaluronate is an effective drug for chondremalacia patellar syndrome, while early treatment and reasonable entry point is the key to keep the therapeutic effects.