关节镜辅助下关节清理术结合腔内注射玻璃酸钠治疗膝关节骨性关节炎的疗效

Efficacy of Arthroscopy-assisted Joint Debridement Combined with Intracavitary Injection of Sodium Hyaluronate in the Treatment of Knee Osteoarthritis

针对膝关节骨性关节炎患者,在关节镜辅助下采取关节清理术结合腔内注射玻璃酸钠治疗,分析该治疗方式的效果。方法:选取我院2019年10月—2020年12月收治的80例膝关节骨性关节炎患者,根据随机抽取双色球方式,将患者分为对照组(关节镜辅助下采取关节清理术治疗,40例)和观察组(在对照组基础上,结合腔内注射玻璃酸钠治疗,40例)。观察并对比2组在治疗总有效率、膝关节功能、疼痛程度以及并发症发生率方面的情况,观察2组的骨代谢指标、细胞因子及生活质量。结果:在治疗总有效率方面,观察组显著高于对照组(P<0.05);在膝关节功能评分与疼痛程度评分方面,2组在治疗前的评分对比均不存在显著差异(P>0.05),膝关节功能评分均在治疗后均升高,疼痛程度评分均在治疗后降低,而观察组在治疗后的膝关节功能评分高于对照组,疼痛程度评分低于对照组(P<0.05);在并发症发生率方面,观察组显著低于对照组(P<0.05);在骨桥蛋白(OPN)、血清转化生长因子-β(TGF-β)、血管内皮生长因子(VEGF)及纤维生长因子-2(FGF-2)水平上,观察组优于对照组(P<0.05);在骨保护素(OPG)、胰岛素样生长因子-1(IGF-1)及血清β胶原降解产物(β-CTX)水平上,观察组优于对照组(P<0.05);在心理功能、社会功能、物质生活以及躯体功能评分上,观察组高于对照组(P<0.05)。结论:针对膝关节骨性关节炎患者,在关节镜辅助下采取关节清理术结合腔内注射玻璃酸钠治疗,对患者的膝关节功能改善效果显著。

Objective:For patients with knee osteoarthritis,arthroscopic-assisted joint debridement combined with intracavitary injection of sodium hyaluronate was used to analyze the effect of this treatment.Methods:The subjects of this study were selected from the patients with knee osteoarthritis admitted to our hospital.The selected patients were all admitted to our hospital from October 2019 to December 2020.A total of 80 patients were selected.According to the method of random selection of two-color balls,the selected patients were divided into the control group(with joint debridement assisted by arthroscopy,a total of 40 cases)and the study group(in addition to the intracavitary injection of sodium hyaluronate,a total of 40 cases).The total effective rate of treatment,knee joint function,degree of pain and the incidence of complications were observed and compared between the two groups,and the bone metabolism indexes,cytokines and quality of life of the two groups were observed.Results:The total effective rate of treatment in the study group was significantly higher than that in the control group(P<0.05);in terms of knee joint function score and pain degree score,there was no significant difference between the two groups before treatment(P>0.05);and the knee joint function scores were increased after treatment,and the pain severity scores were decreased after treatment,while the knee joint function scores of the study group after treatment were higher than those of the control group,and the pain severity scores were lower than those of the control group(P<0.05).The incidence of complications in the study group was significantly lower than that in the control group(P<0.05).The levels of osteopontin(OPN),serum transforming growth factor-β(TCF-β),vascular endothelial growth factor(VEGF)and fibrosis growth factor-2((FCF-2)in the study group were better than those in the control group(P<O.05).The levels of osteoprotegerin(OPG),insulin-like growth factor-1(ICF-1)and serumβ-collagen degradation product(β-CTX)in the study group were better than those in the control group(P<0.05).The scores of psychological function,social function,material life and physical function in the study group were higher than those in the control group(P<0.05).Conclusion:For patients with knee osteoarthritis,joint debridement combined with intracavitary injection of sodium hyaluronate under the assistance of arthroscopy can significantly improve the knee joint function.