膝关节镜手术联合塞来昔布治疗老年人膝骨关节炎的临床效果观察

Clinical effect of knee arthroscopy combined with celecoxib in the treatment of elderly patients with knee osteoarthritis

目的探讨膝关节镜手术联合塞来昔布对老年膝骨关节炎患者临床效果。方法按照随机数字表法将诸暨市第三人民医院2016年10月至2018年10月收治的老年膝骨关节炎患者62例分为对照组31例与观察组31例。对照组采用膝关节镜下清理术治疗。观察组在对照组基础上口服塞来昔布,疗程为12周。比较两组治疗疗效,治疗前后骨关节炎指数(WOMAC)量表评分、膝关节主动屈伸度和炎性因子变化。结果观察组优良率(83.88%)高于对照组(51.62%)(χ2=7.381,P<0.05)。观察组治疗后关节僵硬评分(3.56±0.38)分、日常活动难度评分(27.38±7.19)分和疼痛评分(7.94±2.45)分低于对照组评分(5.81±0.76)分、(38.98±5.42)分和(11.36±1.87)分(t=10.182、14.743、6.178,均P<0.05)。观察组治疗后膝关节主动屈伸度(91.24±7.86)°高于对照组(83.42±7.39)°(t=4.036,P<0.05)。观察组治疗后血清白细胞介素1β(16.58±4.25)ng/L、肿瘤坏死因子α(183.25±24.15)ng/L和白细胞介素6(9.98±2.43)ng/L含量低于对照组的(26.31±5.47)ng/L、(219.82±29.96)ng/L和(14.52±4.35)ng/L(t=7.821、5.291、5.073,均P<0.05)。结论膝关节镜手术联合塞来昔布对老年膝骨关节炎患者临床效果良好,可改善患者膝关节功能及减轻炎性反应,提高膝关节主动屈伸。

Objective To investigate the clinical effect of knee arthroscopy combined with celecoxib in the treatment of elderly patients with knee osteoarthritis.Methods According to the random table method,62 elderly patients with knee osteoarthritis admitted to the Third People's Hospital of Zhuji from October 2016 to October 2018 were divided into control group(31 cases)and observation group(31 cases)according to the digital table.The control group was treated with knee arthroscopic debridement,while the observation group was orally given celecoxib on the basis of the control group.Both two groups were treated for 12 weeks.The curative effect of the two groups was compared,and the changes of WOMAC scale score,knee joint active flexion and extension and inflammatory factors before and after treatment were compared.Results The excellent and good rate of the observation group(83.88%)was higher than that of the control group(51.62%)(χ2=7.381,P<0.05).After treatment,the scores of stiffness[(3.56±0.38)points],difficulty in daily activities[(27.38±7.19)points]and pain[(7.94±2.45)points]in the observation group were lower than those in the control group[(5.81±0.76)points,(38.98±5.42)points and(11.36±1.87)points](t=10.182,14.743,6.178,all P<0.05).After treatment,the knee joint active flexion and extension in the observation group[(91.24±7.86)°]was higher than that in the control group[(83.42±7.39)°](t=4.036,P<0.05).After treatment,the serum levels of IL-1beta[(16.58±4.25)ng/L],TNF-α[(183.25±24.15)ng/L]and IL-6[(9.98±2.43)ng/L]in the observation group were lower than those in the control group[(26.31±5.47)ng/L,(219.82±29.96)ng/L and(14.52±4.35)ng/L](t=7.821,5.291,5.073,all P<0.05).Conclusion Knee arthroscopy combined with celecoxib has good clinical effect on elderly patients with knee osteoarthritis.It can improve knee function,alleviate inflammation and improve active knee flexion and extension.