滑膜切削联合关节松解治疗AS并发髋关节早期病变的临床疗效

CLINICAL EFFECT OF SYNOVIAL MEMBRANE CUTTING COMBINED WITH JOINT RELEASE IN TREATMENT OF AS WITH EARLY HIP DISEASE

目的探讨关节镜下滑膜切削联合关节松解术治疗强直性脊柱炎(AS)并发髋关节早期病变的临床效果。方法采用回顾性研究方法,选取南充市中心医院2014年2月—2019年4月收治的95例AS患者进行研究,其中44例AS并发髋关节早期病变接受关节镜下滑膜切削联合关节松解术治疗患者作为手术组、既往51例AS并发髋关节早期病变接受药物保守治疗的患者作为对照组;比较二组治疗前后不同时间点的髋关节功能评分、髋关节屈曲角度、髋关节外展角度、疼痛程度评分、血清C反应蛋白(CRP)、白细胞介素-12(IL-12)、肿瘤坏死因子-α(TNF-α)、γ-干扰素(IFN-γ)、血沉(ESR)。结果治疗前手术组和对照组的Harris评分、VAS评分差异均无统计学意义(均P>0.05);治疗后3个月、6个月,手术组的哈里斯(Harris)评分高于对照组,VAS评分低于对照组,差异均具有统计学意义(均P<0.05);治疗前手术组和对照组的髋关节髋关节屈曲角度、髋关节外展角度差异均无统计学意义(均P>0.05);治疗后3个月、6个月,手术组的髋关节屈曲角度、髋关节外展角度均高于对照组,差异均有统计学意义(均P<0.05);治疗前及治疗后,手术组和对照组的血清CRP、IL-12、TNF-α、IFN-γ、ESR差异均无统计学意义(均P>0.05);治疗后3个月,二组患者的血清CRP、IL-12、TNF-α、IFN-γ、ESR测定值较本组治疗前均显著降低,差异均有统计学意义(均P<0.05)。结论关节镜下滑膜切削联合关节松解术治疗AS并发早期髋关节早期病变的效果可靠,对于患者髋关节功能恢复具有积极作用。

Objective To investigate the clinical effect of arthroscopic synovial membrane cutting combined with arthrolysis in the treatment of ankylosing spondylitis(AS)complicated with early hip disease.Methods This study adopted a retrospective research method and selected ninety-five patients with AS admitted to Nanchong Central Hospital from February 2016 to April 2019.Among them,44 patients with AS complicatedwith early hip joint early lesions underwent arthroscopic synovial ablation combined with joint loosening.The patients treated with angioplasty were used as the operation group,and the previous 51 patients with AS complicated with early hip joint early disease who received conservative treatment were used as the control group;the hip function scores,hip flexion angle,and external hip joints at different time points before and after treatment were compared between the two groups Spread angle,pain degree score,serum C-reactive protein(CRP),interleukin-12(IL-12),tumor necrosis factor-α(TNF-α),gamma-interferon(IFN-γ),erythrocyte sedimentation rate(ESR).Results Before treatment,there was no significant difference in Harris score and VAS score between the operation group and the control group(P>0.05);3 months and 6 months after treatment,the Harris score of the operation group was higher than that of the control group(P<0.05),The VAS score was lower than that of the control group(P<0.05);before treatment,there was no statistically significant difference in hip flexion angle and hip abduction angle between the surgery group and the control group(P>0.05);3 months after treatment,At 6 months,the hip flexion angle and hip abduction angle of the surgery group were higher than those of the control group(P<0.05);before and after treatment,the serum CRP,IL-12,TNF-α,There was no statistically significant difference in IFN-γand ESR(P>0.05);3 months after treatment,the measured values of serum CRP,IL-12,TNF-α,IFN-γ,and ESR in the two groups were higher than those in this group before treatment significantly reduced(P<0.05).Conclusion Arthroscopic synovial membrane cutting combined with arthrodesis is effective in the treatment of AS complicated with early hip disease and has a positive effect on the recovery of hip function in patients.