关节腔注射玻璃酸钠及罗哌卡因联合关节镜清理术对膝关节骨性关节炎的临床效果

Curative Efficacy of Articular Cavity Injection of Sodium Lyaluronate and Ropivacaine combined with Arthroscopic Debridement in treatment of Osteoarthritis of the Knee

目的:探讨关节腔注射玻璃酸钠及罗哌卡因联合关节镜清理术对膝关节骨性关节炎的临床效果。方法:选择2016年2月至2018年2月我院接诊的膝关节骨性关节炎患者100例作为研究对象,以简单随机分组法分为观察组(n=51)和对照组(n=49),对照组使用关节镜清理术治疗,观察组采用关节腔注射玻璃酸钠及罗哌卡因联合关节镜清理术治疗。比较两组治疗后疗效、炎性指标[白细胞介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]、膝关节功能评分(HSS)疼痛视觉模拟评分(visualanalogue scale,VAS)、术后恢复时间及生活质量。结果:治疗后,两组患者优良率分别84.31%、65.31%,比较差异具有统计学意义(P<0.05);两组患者治疗前炎性指标水平无明显差异;治疗后,两组患者炎性指标水平均明显下降,且观察组患者IL-1β、TNF-α、IL-6水平均显著低于对照组(P<0.05);两组患者治疗前VAS、HSS评分无明显差异;治疗后,两组VAS评分均明显下降,HSS评分明显升高,且观察组HSS评分显著高于对照组,VAS评分显著低于对照组(P<0.05);治疗后,观察组术后恢复时间显著低于对照组,生活质量评分显著高于对照组(P<0.05)。结论:在膝关节骨性关节炎患者中使用关节腔注射玻璃酸钠及罗哌卡因联合关节镜清理术效果显著,可有效改善患者膝关节功能及炎性指标水平,值得推广与运用。

Objective:To study curative efficacy of Articular cavity injection of sodium hyaluronate and ropivacaine combined with arthroscopic debridement in treatment of Osteoarthritis of the knee.Methods:100 cases of knee osteoarthritis patients admitted to our hospital from February 2016 to February 2018 were selected as the research objects,randomized number table method was used to divide the observation group(n=51)and the control group(n=49).The control group was treated with arthroscopic debridement,and the observation group was treated with sodium hyaluronate injection and ropivacaine combined with arthroscopic debridement.After treatment,the efficacy,inflammatory indexes[interleukin-1 beta(il-1),tumor necrosis factor alpha(tnf-alpha),interleukin-6(il-6)],knee joint function score(HSS),visualanalogue scale of pain(VAS),postoperative recovery time and quality of life of the two groups were compared.Results:After treatment,the excellent and good rates of patients in the two groups were 84.31%and 65.31%respectively,with statistically significant difference(P<0.05).There was no significant difference in pre-treatment inflammatory index between the two groups.After treatment,the levels of inflammatory indexes in both groups were significantly decreased,and the levels of il-1 beta,tnf-alpha and il-6 in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in VAS and HSS scores between the two groups before treatment.After treatment,VAS score in both groups decreased significantly,and HSS score in the observation group was significantly higher than that in the control group,and VAS score was significantly lower than that in the control group(P<0.05).After treatment,the postoperative recovery time of the observation group was significantly lower than that of the control group,and the quality of life score was significantly higher than that of the control group(P<0.05).Conclusion:Intra-articular injection of sodium hyaluronate and ropivacaine combined with arthroscopic debridement in patients with knee osteoarthritis has a significant effect,which can effectively improve the knee function and inflammatory index level of patients,and is worthy of promotion and application.