终末期踝关节创伤性关节炎患者应用关节镜下踝关节融合术治疗对其Baird-Jackson评分及关节液炎性因子水平的影响

Effects of Arthroscopic Ankle Arthrodesis on the Baird-Jackson Score and Levels of Synovial Fluid Inflammatory Factors in Patients with End-stage Ankle Joints

目的:探究终末期踝关节创伤性关节炎(TA)患者应用关节镜下踝关节融合术(TTCA)治疗对其BairdJackson评分及关节液炎性因子水平的影响。方法:选取2018年3月——2019年3月中国人民解放军联勤保障部队第九九〇医院收治的63例终末期踝关节TA患者为研究对象,使用区组随机化分组将其分为A组32例和B组31例。B组给予开放性手术,A组给予关节镜下TTCA。比较两组患者围术期基本情况(手术时间、术中出血量、住院时间),分析手术前、术后3个月时两组患者Baird-Jackson评分、关节液炎性因子水平[白细胞介素-1(IL-1)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]。结果:A组手术时间、术中出血量、住院时间均显著低于B组,差异有统计学意义(t=14.817、25.218、4.954,P<0.05)。术后3个月时,两组患者Baird-Jackson评分、IL-1、IL-6、TNF-α水平较手术前显著降低,差异有统计学意义(t=6.969、2.847、2.719、2.997,P<0.05)。结论:关节镜下TTCA治疗终末期踝关节TA患者疗效显著,能改善其围术期基本情况,促进踝关节功能恢复,降低炎症反应,具有较高临床应用价值。

Objective:To explore the effect of arthroscopic ankle arthrodesis(TTCA)on the Baird-Jackson score and the level of synovial fluid inflammatory factors in patients with end-stage ankle(TA).Methods:A total of 63 patients with end-stage ankle TA were selected and divided into group A(32 cases)and group B(31 cases)by block randomization.Group B was given open surgery,and group A was given arthroscopic TTCA.The perioperative basic conditions(operation time,intraoperative blood loss,hospital stay)of the two groups were compared.Baird Jackson score,inflammatory factor levels in synovial fluid(interleukin-1[IL-1],interleukin-6[IL-6],tumor necrosis factor-α[TNF-α])of the two groups before and 3 months after operation were analyzed.Results:The operation time,intraoperative blood loss and hospital stay in group A were significantly lower than those in group B,and the differences were statistically significant(t=14.817,25.218,4.954,P<0.05).At 3 months after operation,the Baird-Jackson score,IL-1,IL-6 and TNF-αlevels in the two groups were significantly lower than those before operation,and the differences were statistically significant(t=6.969,2.847,2.719,2.997,P<0.05).Conclusion:TTCA under arthroscopy is effective in the treatment of end-stage ankle TA patients,which can improve the basic situation of perioperative period,promote the recovery of ankle function,reduce inflammatory reaction,and has high clinical application value.