超声引导膝感觉神经射频治疗膝骨关节炎的临床观察

Clinical study of genicular nerve radiofrequency ablation in knee osteoarthritis treatment

目的:评价超声引导膝感觉神经射频消融术(radiofrequency ablation,RFA)治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效。方法:选取2022年1月至2023年1月中日友好医院疼痛科收治的112例符合纳入标准的慢性中重度KOA病人,按随机数字表分为对照组(n=56)和射频组(n=56),射频组采用超声引导膝感觉神经RFA治疗,对照组采用超声引导神经阻滞治疗。分别于治疗前和治疗后1、3、6个月采用疼痛数字分级评分法(numerical rating scale,NRS)评分、牛津大学膝关节评分(Oxford knee score,OKS)、整体感知疗效(global perceived effect,GPE)评估病人疼痛程度、膝关节功能及满意度,并记录病人不良反应。结果:治疗后1、3、6个月射频组NRS评分较对照组显著降低(P<0.01),OKS评分较对照组显著升高(P<0.01),GPE评分优于对照组(P<0.05)。两组均未发生严重不良反应。结论:超声引导膝感觉神经RFA能够降低中重度KOA病人的疼痛,改善膝关节功能状态,提高病人满意度,为中重度KOA的治疗提供一种可行安全有效的微创治疗方案。

Objective:To observe the clinical effectiveness of ultrasound-guided genicular nerve radiofrequency ablation(RFA)in knee osteoarthritis(KOA)treatment.Methods:From January 2022 to January 2023,112 patients with KOA who met the inclusion criteria were enrolled from the pain department of China-Japan Friendship Hospital.They were divided into Control group(n=56)or RFA group(n=56)according to the random number table.The RFA group was treated with ultrasound-guided RFA of genicular nerves,while the Control group was treated with ultrasound-guided nerve block.Outcome assessments were performed at baseline and at the 1th,3th and 6th month post-treatment with the numerical rating scale(NRS),Oxford knee score(OKS),Global perceived effect(GPE),and their adverse reaction was recorded.Results:At the 1^(th),3^(th)and 6^(th) month post-treatment,the NRS scores of the RFA group were significantly lower than those in the Control group(P<0.01);The OKS scores were significantly higher than that of the Control group(P<0.01);The GPE scores were better than that of the Control group(P<0.05).No serious adverse reactions occurred in both groups.Conclusion:Ultrasound guided RFA of genicular nerves may significantly alleviate pain,improve knee joint function,increase patient satisfaction,and provide a feasible safe and effective minimally invasive treatment scheme in moderate to severe KOA.