髋关节镜下滑膜切削在治疗强直性脊柱炎中的临床疗效观察

Clinical outcomes of arthroscopic synovial excision in the treatment of ankylosing spondylitis.

目的观察髋关节镜下滑膜切削治疗强直性脊柱炎的临床疗效。方法回顾性分析2016年1月至2019年1月兰州市西固区人民医院接收的69例强直性脊柱炎患者临床资料,根据治疗方法不同分为对照组33例、观察组36例,对照组采用传统开放手术治疗,观察组采用髋关节镜下滑膜切削治疗。比较2组疼痛程度、生理指标、关节功能评分、关节活动度、不良反应。结果术后6、12个月,观察组Harris评分为(76.39±7.71)、(85.20±9.15)分,均高于对照组[(70.51±6.82)、(77.30±7.46)分],差异均有统计学意义(P<0.05)。术后12个月,观察组外展角度、屈曲角度为(31.60±4.69)°、(96.55±10.46)°,均高于对照组[(27.51±3.38)°、(84.82±8.70)°],差异均有统计学意义(P<0.05)。术后6、12个月,观察组VAS评分为(2.26±0.52)、(2.04±0.45)分,均低于对照组[(3.80±0.79)、(3.14±0.67)分],差异均有统计学意义(P<0.05)。术后1个月,观察组ESR、CRP水平为(21.43±3.15)mm/h、(5.20±2.16)mg/L,低于对照组[(3.80±0.79)mm/h、(3.14±0.67)mg/L],差异均有统计学意义(P<0.05)。观察组不良反应发生率5.56%低于对照组24.24%,但两组比较差异无统计学意义(P>0.05)。结论采用髋关节镜下滑膜切削治疗强直性脊柱炎致髋关节病变可显著改善患者生理指标,提高关节功能和活动度,减低疼痛程度,且不良反应发生率较低。

Objective To investigate the effect of arthroscopic synovial excision in the treatment of ankylosing spondylitis.Methods The clinical data of 69 patients with ankylosing spondylitis in People's Hospital of Xigu District,Lanzhou City,from January 2016 to January 2019 were retrospectively analyzed.Patients were divided into two groups according to different treatment methods.The control group(n=33)was received open surgery,while the observation group(n=36)was received arthroscopic synovial excision.Pain degree,physiological indexes,joint function score,range of motion and adverse reactions were compared between two groups.Results The Harris scores in the observation group at 6 and 12 months after operation were(76.39±7.71)and(85.20±9.15)points,which were higher than those in the control group[(70.51±6.82),(77.30±7.46)points],and the differences were statistically significant(P<0.05).The abduction angle and flexion angle in the observation group at 12 months after operation were(31.60±4.69)°,(96.55±10.46)°,which were higher than those in the control group[(27.51±3.38)°,(84.82±8.70)°],the difference were statistically significant(P<0.05).The VAS scores in the observation group at 6 and 12 months after operation were(2.26±0.52)and(2.04±0.45)points,which were lower than those in the control group[(3.80±0.79),(3.14±0.67)points],the differences were statistically significant(P<0.05).The levels of ESR and CRP in the observation group at 1 month after operation were(21.43±3.15)mm/h and(5.20±2.16)mg/L,which were lower than those in the control group[(3.80±0.79)mm/h,(3.14±0.67)mg/L],the differences were statistically significant(P<0.05).The incidence of adverse reactions in the observation group was slightly lower than that in the control group,but there was no significant difference(5.56%vs 24.24%,P>0.05).Conclusion Application of arthroscopic synovial excision in the treatment of ankylosing spondylitis can effectively ameliorate the physiological indicators,improve joint function and mobility,and alleviate pain degree,with low adverse reaction rate.