关节腔注射治疗对不同年龄段颞下颌关节骨关节炎患者的疗效评价

Effect of articular cavity injection for patients with temporomandibular joint osteoarthritis at different ages

目的：评价5周一个疗程的关节灌洗术联合透明质酸钠注射对不同年龄段颞下颌关节骨关节炎患者的疗效。方法：选取颞下颌关节骨关节炎患者47例,按年龄段不同分为青年组（〈45岁）、中年组（45~65岁）和老年组（〉65岁）3组。所有患者均接受5周一个疗程的关节灌洗联合透明质酸钠关节腔注射术。在试验基线和治疗后的第1、3、6个月,分别检测各试验组非辅助最大开口度、休息时及咀嚼时疼痛感以及关节运动功能障碍。在试验基线和治疗后第6个月使用OHIP-14量表测量患者的生存质量。使用SPSS18.0软件包对数据进行统计学处理。结果：各组患者治疗后生存质量均显著提高（P〈0.05）;青年组（〈45岁）患者休息时疼痛感在治疗后得到明显缓解（P〈0.05）;中年组（45~65岁）患者治疗后最大开口度明显增加,下颌运动功能障碍明显改善（P〈0.05）;老年组（〉65岁）患者所有检测指标均显著优于治疗前（P〈0.05）,临床症状的改善程度明显优于其他2组（P〈0.05）。结论：颞下颌关节骨关节炎的临床疗效与年龄相关,老年患者能获得更好的整体疗效。

PURPOSE： To evaluate the effect of a course of 5 weeks of joint lavage combined with sodium hyaluronate injection on temporomandibular joint osteoarthfitis patients at different ages. METHODS： Forty-seven patients with temporomandibular joint osteoarthritis were selected and divided into 3 groups including young group （〈45 years old）, middle-aged group （45-65 years old） and aged group （〉65 years old）. All the patients underwent a course of 5 weeks of joint lavage combined with sodium hyaluronate injection. Non-assisted maximum opening degree of mouth, the joint pain at rest and during chewing and the joint movement disorders were measured in each group at baseline and 1, 3, 6 months after treatment, The patients were measured for the quality of life at baseline and 6 months after treatment by using OHIP- 14 scale. The data was processed by using SPSS 18.0 software package. RESULTS： The qualities of life were significandy improved for each group of patients （,~〈0.05）. The rest pain of patients in young group （〈45 years old） were significantly alleviated after treatment （/~〈0.05）. The maximum opening of month and the mandibular movement dysfunction were improved significantly in patients of middle age group （45-65 years old） after treatment （P〈0.05）. All the indexes detected in the aged group after treatment （〉65 years old） were significantly better than those before treatment （P〈0.05） and the improvement of clinical symptoms were significantly better than that of the other 2 groups （P〈0.05）. CONCLUSIONS： The clinical efficacy of temporomandibular joint osteoarthritis is related to the age and the elderly patients can obtain better overall efficacy.