关节镜清理术联合玻璃酸钠注射治疗膝关节骨性关节炎的临床观察

Clinical observation of arthroscopic debridement combined with sodium hyaluronate injection for knee osteoarthritis

目的探讨关节镜清理术联合玻璃酸钠药物注射治疗膝关节骨性关节炎的临床效果。方法将2017年6月至2019年3月本院收治的98例膝关节骨性关节炎患者按随机数字表法分为试验组与对照组,各49例。试验组接受关节镜清理术联合玻璃酸钠药物注射治疗,对照组接受单独关节镜清理术治疗。观察两组治疗前后关节疼痛程度、关节液炎症细胞因子表达、膝关节功能及并发症发生率。结果相较于治疗前、治疗后24小时、4个月两组关节疼痛VAS评分均降低,且试验组评分低于对照组,差异有统计学意义(P<0.05)。相较于治疗前,治疗后4个月两组关节液内IL-1β、TNF-α表达均降低,且试验组IL-1β、TNF-α表达分别为(309.64±20.48)pg/ml、(425.37±32.24)pg/ml,低于对照组的(328.76±21.63)pg/ml、(463.31±35.09)pg/ml,差异有统计学意义(P<0.05)。相较于治疗前,治疗后4个月两组膝关节功能均改善,且试验组(79.53±1.57)分高于对照组的(70.36±1.68)分,差异有统计学意义(P<0.05)。两组并发症总发生率对比(14.29%vs 10.20%),差异无统计学意义(P>0.05)。结论关节镜清理术联合玻璃酸钠药物注射治疗膝关节骨性关节炎疗效确切,能减轻或消除关节疼痛等症状,降低炎症反应,改善患者膝关节功能,且并发症少,值得推广。

Objective To explore the clinical effect of arthroscopic debridement combined with sodium hyaluronate injection in the treatment of knee osteoarthritis.Methods 98 patients with knee osteoarthritis treated in our hospital from June 2017 to March 2019 according to the random number table method,they were divided into experimental group and control group,each with 49 cases.The experimental group received arthroscopic debridement combined with sodium hyaluronate injection,and the control group received arthroscopic debridement alone.The degree of joint pain before and after treatment was observed.The expression of inflammatory cytokines in synovial fluid,knee joint function,and the incidence of complications.Results Compared with before treatment,the VAS scores of joint pain in both groups were reduced at 24 hours and 4 months after treatment,and the test group(3.40±1.53)scores,(2.16±1.40)points,lower than(4.59±1.64)points and(2.92±1.47)points in the control group,the difference was statistically significant(P<0.05);compared with the two groups before treatment,4 months after treatment The expressions of IL-1βand TNF-αin synovial fluid were reduced,and the expressions of IL-1βand TNF-αin the experimental group were(309.64±20.48)pg/ml and(425.37±32.24)pg/ml,which were lower than those in the control group(328.76±21.63)pg/ml,(463.31±35.09)pg/ml,the difference was statistically significant(P<0.05);compared with before treatment,4 after treatment.The knee function of both groups was improved,and the test group(79.53±1.57)points were higher than the control group(70.36±1.68)points,the difference was statistically significant(P<0.05);the total incidence of complications was compared between the two groups(14.29%vs 10.20%),the difference was not statistically significant(P>0.05).Conclusion Arthroscopic debridement combined with sodium hyaluronate injection for the treatment of knee osteoarthritis is effective and can reduce or eliminate joint pain and other symptoms.It can reduce the inflammatory response and improve the knee function of patients with fewer complications,which is worth promoting.