关节镜手术联合透明质酸钠在老年膝骨关节炎治疗的效果及炎性因子的影响

Application of arthroscopic surgery combined with sodium hyaluronate in treatment of senile knee osteoarthritis and its effects on inflammatory factors of patients

目的探讨临床中关节镜手术结合透明质酸钠联合治疗老年膝骨关节炎的临床疗效及其对炎性因子的影响。方法收集2017年1月至2018年6月的老年膝骨关节炎患者110例作为研究对象,将其按照随机数字表法分为联合组与对照组,每组55例。对照组给予常规关节镜手术治疗,联合组在关节镜手术基础上给予透明质酸钠治疗,观察2组治疗效果和炎性因子的变化。结果联合组手术时间高于对照组,而关节愈合时间、完全负重功能锻炼时间、住院时间均低于对照组,差异有统计学意义(P<0.05);手术后2组Lysholm评分均较手术前明显的提高,且联合组提高程度优于对照组,差异有统计学意义(P<0.05)。手术后2组IL-1、IL-6和TNF-a值均较手术前明显的改善,差异有统计学意义(P<0.05)。结论临床中对于老年膝骨关节炎患者给予关节镜手术结合透明质酸钠治疗是可行的,能够有效的缩短术后住院时间,并且有效改善炎性因子和膝关节功能,值得临床中应用推广。

Objective To investigate the clinical efficacy of arthroscopic surgery combined with sodium hyaluronate in treatment of knee osteoarthritis in the elderly and its effects on inflammatory factors of patients. Methods A total of 110 elderly patients with knee osteoarthritis who were treated in our hospital from January 2017 to June 2018 were enrolled in the study. The patients were divided into combination treatment group ( n =55) and control group ( n =55) according to the random number table.The patients in control group were treated by conventional arthroscopic surgery,however,the patients in combination treatment group, on the basis of control group, were treated by sodium hyaluronate. The therapeutic effects and the changes of inflammatory factors were observed and compared between the two groups. Results The operation time in combination treatment group was significantly longer than that in control group,however, the time of joint healing,the time of complete weight-bearing exercise, and hospitalization time in combination treatment group were significantly shorter than those in control group ( P <0.05).After surgery the Lysholm scores in both groups were significantly higher than those before surgery,moreover,which in combination treatment group were significantly higher than those in control group ( P <0.05).In addition after operation, the levels of IL-1, IL-6 and TNF-α in both groups were significantly improved,as compared with those before surgery ( P <0.05). Conclusion It is feasible to treat knee osteoarthritis in the elderly by arthroscopic surgery combined with sodium hyaluronate,which can effectively shorten the postoperative hospital stay and effectively improve inflammatory factors and knee joint function of patients,thus, it is worthy of clinical application and promotion.