曲安奈德对骨性膝关节炎患者关节镜清理术后运动功能的影响

Effect of Triamcinolone Acetonide on the Movement Function of Patients with Osteoarthritis

目的探讨关节镜清理术后加用曲安奈德对骨性膝关节炎患者运动功能的影响。方法将84例骨性膝关节炎患者随机分为观察组和对照组,各42例。对照组行关节镜清理术,观察组在对照组基础上术后于关节腔内注射曲安奈德。分别于术前、术后1,3,6个月应用Fugl-Meyer运动功能积分法(FMA)、Barthel指数、WHO生存质量测定量表简表(WHO QOL-BREF)对两组患者运动功能及生活质量进行评价,记录不良反应发生情况。结果与对照组相比,观察组患者总有效率显著升高(P<0.05)。对照组患者治疗3个月后FMA评分明显升高,观察组患者治疗1个月后显著升高(P<0.05),且观察组患者FMA评分较同期对照组显著升高(P<0.05)。两组患者治疗前Barthel指数间未见明显差异(P>0.05),治疗后两组患者较治疗前均有显著升高(P<0.05)。治疗2个月后,观察组患者FMA评分较同期对照组显著升高(P<0.05)。对照组患者治疗第3个月后QOL-BREF评分明显升高(P<0.05),观察组患者治疗1个月后显著升高(P<0.05),且观察组患者QOL-BREF评分较同期对照组显著升高(P<0.05)。两组患者不良反应发生率比较未见明显差异(P>0.05)。结论关节镜清理术后加用曲安奈德关节腔内注射,能有效提高骨性膝关节炎治疗效果,改善运动功能,提高生活质量,安全性好,值得临床推广。

Objective To investigate the effect of adding triamcinolone acetonide on the movement function of patients with knee osteoarthritis. Methods 84 cases of patients with osteoarthritis were randomly divided into the observation group and control group,42 cases in each group. The control group was treated with arthroscopic debridement,and the observation group was added with triamcinolone acetonide on the basis ofthe control group during postoperative period. The movementfunction and quality of life were evaluated in the preoperative and postoperative 1,3 and 6 months respectively by Fugl Meyer integral method（ FMA）,Barthel index,WHO quality of life scale for（ WHO QOL- BREF）. At the same time, the differences of adverse reactions in the treatment of the two groups were observed. Results The total effective rate of the observation group was significantly higher than that of the control group（ P〈0. 05）.The FMA score of the control group increased significantly since the treatment after the 3rd months, while the observation group was significantly higher since the treatment after the 1st month. In addition,the FMA score of the observation group was significantly higher than that of the control group during the same period. There was no significant difference in the Barthel index between the two groups before treatment（ P〈0. 05）. And after treatmentthe two groups were significantly elevated than before treatment. In addition, the FMA score of the observation group was significantly higher than that of the control group since the 2rd month（ P〈0. 05）. There were no significant differences in the scores of QOL- BREF between the two groups before treatment（ P〈0. 05）. The index of the control groupincreased significantly after the 3rd month, while the observation group had a significant rise after the 1st month. In addition, the QOL- BREF score of the observation group was significantly higher than that of the control group after the 1st month（ P〈0. 05）.There was no significant difference in the incidence of adverse reactions between the twogroups（ P〈0. 05）. Conclusion Intra- articular injection of triamcinolone acetonide combined with arthroscopic debridement can effectively improve the therapeutic effect of bone in patients withknee osteoarthritis and improve the movement function in patients and the quality of life.