关节镜肘关节有限清理及松解术对风湿性关节炎肘关节僵直DAS28-CRP、HAQ等评分的影响及安全性分析

The effect of arthroscopic elbow joint limited clearance and release on DAS28-CRP,HAQ and other scores of elbow joint stiffness in rheumatoid arthritis(RA)and its safety analysis

目的探究分析风湿性关节炎肘关节僵直患者接受关节镜肘关节有限清理并配以松解术联合治疗方案对其DAS 28-C反应蛋白检验结果、健康评估问卷(HAQ)评分结果的影响情况以及安全性。方法选取2022年1月-12月收治风湿性关节炎肘关节僵直患者33例,均在局部浸润麻醉下接受关节镜有限清理术,且对挛缩的关节囊与侧副韧带实施松解术,术后2周行随访调查,评价分析疾病活动评分(DAS 28-CRP检测结果、HAQ评分、Mayo肘关节功能评分、ROM屈伸功能评分)以及安全性情况。结果⑴相较于术前,术后2周DAS 28-CRP检测结果、HAQ结果改善效果明显,差异有统计学意义(P<0.05);⑵相较于术前,术后2周Mayo肘关节评分功能改善效果明显,日常活动能力明显升高,差异有统计学意义(P<0.05);⑶相较于术前,术后2周肘关节屈伸功能改善明显,差异有统计学意义(P<0.05)。肘关节僵直时间≥12个月的患者术后关节屈伸功能恢复程度,相较于<12个月患者明显较差,差异有统计学意义(P<0.05);⑷术后情况恢复良好,并发症发生率为0.00%。结论在风湿性关节炎肘关节僵直治疗中,运用关节镜肘关节有限清理并配以松解术联合治疗方案,能够有效改善患者的疼痛感,提高患者肘关节屈伸活动度,治疗安全性比较高,不会对患者自身带来极大伤害,使患者早日回归生活。

Objective To explore and analyze the influence and safety of arthroscopic elbow joint limited cleaning combined with release surgery on the DAS 28 C-reactive protein test results and the score results of the health assessment questionnaire of patients with rheumatoid arthritis elbow stiffness.Methods A total of 33 patients with rheumatoid arthritis and elbow stiffness admitted to our hospital were selected.The time distribution was from January 2022 to December 2022,all patients were treated with arthroscopic limited clearance under local infiltration anesthesia,and the contracture joint capsule and lateral collateral ligament were released,follow-up survey was conducted 2 weeks after the operation,the patients'disease activity score(DAS 28 C-reactive protein score,health assessment questionnaire score,mayo elbow function score,ROM flexion and extension function score)and safety were evaluated and analyzed.Results Compared with the results before operation,the DAS 28-C reactive protein score and the results of health assessment questionnaire of patients 2 weeks after operation improved significantly(P<0.05);Compared with the pre operation,the Mayo elbow joint score of the patients improved significantly after 2 weeks after the operation,and their daily activity ability increased significantly(P<0.05);Compared with those before the operation,the elbow flexion function and extension and flexion function of patients were significantly improved 2 weeks after the operation(P<0.05);The recovery of elbow joint extension and flexion function of patients with elbow joint stiffness more than 12 months after operation was significantly worse than that of patients with elbow joint stiffness less then 12 months,the difference was P<0.05;the postoperative condition recovered well,and the probability of complications was 0.00%.Conclusion In the treatment of elbow stiffness of rheumatoid arthritis,the use of arthroscopic elbow joint limited clearance combined with release surgery can effectively improve the patient's pain sense,improve the patient's elbow joint flexion and extension range of motion,and the treatment safety is relatively high,which will not cause great harm to the patient itself,so that the patient can return to life as soon as possible.