菱形阻滞与膝关节周围神经阻滞术以及两者联合治疗膝关节骨性关节炎临床疗效对比

Comparison of clinical efficacy between rhomboid block and peripheral nerve block of knee joint and their combined treatment for knee osteoarthritis

目的对比菱形阻滞与膝关节周围神经阻滞术以及两者联合治疗膝关节骨性关节炎临床疗效。方法膝关节骨性关节炎患者92例,随机分为三组,A组29例患者(膝关节周围神经阻滞术组)、B组32例患者(菱形阻滞注射组)、C组31例患者(膝关节周围神经阻滞术联合菱形阻滞注射组)。在治疗前及治疗结束后3 d、7 d、1个月、6个月行VAS视觉模拟评分和Lysholm膝关节康复量表评分以及比较疼痛缓解率、膝关节康复缓解率。比较第二次、三次治疗比率,记录治疗和随访期间不良反应。结果A组在治疗后1个月内VAS、Lysholm评分与治疗前比较差异有统计学意义(P<0.05);B组、C组在治疗后各时间点VAS、Lysholm评分与治疗前比较差异有统计学意义(P<0.05);B组、C组在治疗7 d后疼痛缓解有效率、膝关节康复缓解有效率均显著高于A组(P<0.05);C组第二次、三次治疗比率显著低于A组、B组(P<0.05);3组均未见明显不良反应发生。结论膝关节周围神经阻滞术联合菱形阻滞注射治疗膝关节骨性关节炎更为有效,无明显不良反应。

Objective To compare the clinical efficacy of rhomboid block and peripheral nerve block of knee joint and their combined treatment for knee osteoarthritis.Methods 92 patients with knee osteoarthritis were randomly divided into 3 groups,29 patients in group A(knee peripheral nerve block group),32 patients in group B(rhomboid block group)and 31 patients in group C(knee peripheral nerve block combined with rhomboid block group).Visual analogue scale(VAS)and Lysholm Scale were performed before treatment and at 3 d,7 d,1 month and 6 months after treatment,and the pain relief rate and knee rehabilitation remission rate were compared.The ratio of the second and third treatments were compared,and adverse reactions during treatment and follow-up was recorded.Results In group A,the VAS and Lysholm scores within 1 month after treatment were significantly different from those before treatment(P<0.05);The VAS and Lysholm scores of group B and group C at each time point after treatment were significantly different from those before treatment(P<0.05);7 days after treatment,the pain relief efficiency and knee rehabilitation relief efficiency in group B and C were significantly higher than that in group A(P<0.05);The ratio of the second and third treatments of group C were significantly lower than those of group A and B(P<0.05);No obvious adverse reactions were observed in the 3 groups.Conclusion Peripheral nerve block combined with rhomboid block is more effective in the treatment of knee osteoarthritis with⁃out obvious adverse reactions.