关节镜下有限清理术和广泛清理术在治疗膝关节骨关节炎中的临床应用价值

The clinical application of arthroscope with limited debridement and extensive debridement in treating knee osteoarthritis

目的回顾性分析关节镜下有限清理术和广泛清理术治疗膝关节骨关节炎(KOA)的临床效果,探讨两种术式的临床应用价值。方法选择2015年1月~2016年12月在北京中医药大学第三附属医院住院行关节镜手术治疗的KOA患者88例,其中行关节镜下有限清理术者45例设为有限组,行关节镜下广泛清理术者43例设为广泛组。比较两组治疗的总有效率,手术时间和住院时间等情况。结果在治疗总有效率方面,两组差异无统计学意义(P>0.05)。有限组手术时间和住院时间比广泛组明显缩短,差异有统计学意义(P<0.05)。结论关节镜下有限清理术和广泛清理术治疗KOA临床效果相似。有限清理术手术时间短,创伤相对较小,恢复快;而广泛清理术不能进一步改善需要过多手术清理患者的症状;因此有选择的有限清理术要优于盲目的广泛清理术。

Objective To retrospectively analyze the clinical effects of limited debridement and extensive debridement under arthroscopy in the treatment of knee osteoarthritis （KOA）, in order to discuss the clinical value of the two methods. Methods From January 2015 to December 2016, 88 patients with KOA treated by arthroscopic surgery in the Third Affiliated Hospital of Beijing University of Chinese Medicine were selected and divided into finite group （45 cases） and broad group （43 cases）. The patients in the finite group were treated by limited debridement, and the patients in the broad group were treated by extensive debridement. The total effective rate, operation time and hospitalization time were compared between the two groups. Results There was no statistically significant difference between the two groups in total effective treatment （P 〉 0.05）. The operation time and hospitalization time in the finite group were significantly shorter than those in the broad group, with statistically significant difference （P 〈 0.05）. Conclusion The clinical effect of limited arthroscopic debridement and extensive debridement in treating KOA is similar. Limited debridement has advantages, such as shorter operation time, less trauma, rapid recovery, compared with extensive debridement; while extensive debridement cannot further improve the symptoms of patients requiring too much surgery. Therefore selective limited debridement is better than blind extensive debridement.