局部应用凝血酶对膝关节镜术后关节腔积血的影响

Effect of local application of hemocoagulase on articular cavity hematocele after arthroscopic surgery

目的探讨膝关节镜术后关节腔注射尖吻蝮蛇血凝酶对关节腔积血的影响。方法选择2012年9月至2014年9月该院22-44岁48例半月板损伤患者作为研究对象,将其随机分为生理盐水对照组和尖吻蝮蛇血凝酶2IU组、尖吻蝮蛇血凝酶3IU组。在膝关节镜术后关节腔注射等量生理盐水和2IU或者3IU尖吻蝮蛇血凝酶,分别在术后第1天和第3天用软尺测量髌骨上极2cm周径观察髌上囊充盈情况,应用视觉模拟评分法（VAS）评估疼痛情况,术后1个月采用Lysholm评分评估患者膝关节功能。结果与生理盐水对照组相比,术后第1天和第3天尖吻蝮蛇血凝酶2IU组和3IU组均能够有效地减轻关节肿胀程度,并能够明显减轻疼痛。术后1个月Lysholm评分提示尖吻蝮蛇血凝酶注射组能促进患者术后膝关节功能的恢复（P〈0.05）。结论膝关节镜术后关节腔内注射尖吻蝮蛇血凝酶能减少关节腔积血,减轻患者术后早期疼痛,促进患者术后膝关节功能的恢复。

Objective To analyze the effect of articular cavity injection of hemocoagulase agkistrodon on articular cavity hematocele after arthroscopic surgery.Methods 48 patients aged 22-44 years old with meniscus injury in our hospital from September 2012 to September 2014 were selected as the research subjects and randomly divided into three groups：the normal saline control group,hemocoagulase agkistrodon 2IU group（2IU）and haemocoagulase agkistrodon 3IU group（3IU）.The same dose of normal saline and hemocoagulase agkistrodon 2IU or 3IU were intra-articularly injected after arthroscopic surgery.The flexible rule was used to measure the knee cross-section diameter at 2cm of superior patellar pole on postoperative 1,3dfor observing the filling situation of suprapatellar bursa.The VAS scoring was applied to evaluate the pain situation.The Lysholm scoring was adopted to assess the knee joint function after 1 month of arthroscopic surgery.Results Compared with the normal saline control group,the joint swelling degree on postoperative 1,3din the hemocoagulase agkistrodon 2IU and 3IU groups were effectively alleviated and the pain could be significantly decreased.The Lysholm scores in postoperative 1month indicated that the hemocoagulase agkistrodon injection groups could promote the recovery of the knee joint function（P〈0.05）.Conclusion Applying the intra-articular injection of hemocoagulase agkistrodon after arthroscopic surgery can decrease the articular cavity hematocele,alleviates the early postoperative pain and promotes the recovery of the knee joint function.