药物注射联合关节镜清理术对膝骨性关节炎患者血清炎症因子及疗效的影响

Effect of drug injection combined with arthroscopic debridement on serum inflammatory factors and therapeutic effects in patients with knee osteoarthritis

目的探究药物注射联合关节镜清理术对膝骨性关节炎(KOA)患者血清炎症因子及疗效的影响。方法将2014年1月～2016年1月入院的120例KOA患者采用随机数字表分为研究组和对照组,每组60例。两组均实施关节镜清理术,研究组增加关节腔内玻璃酸钠、得宝松及罗哌卡因注射。对比治疗前后两组患者血清炎症因子[C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)]水平,记录治疗5周后膝关节疼痛状况[视觉模拟评分(VAS评分)],并随访1年以评估关节功能[膝骨性关节炎治疗效果评定标准(JOA评分)]和临床疗效。结果治疗5周后,两组的CRP、IL-6、TNF-α水平均较治疗前下降(P<0.05或0.01),且研究组降幅大于对照组(P<0.01)。随访1年后,研究组的临床优良率高于对照组,差异有统计学意义(P<0.05)。随访1年时,两组JOA评分均较治疗前上升(P<0.05),研究组增幅大于对照组(P<0.05)。结论关节镜清理术联合药物注射能提升KOA治疗效果,有利于关节功能恢复、降低患者炎症因子水平。

Objective To investigate the effects of drug injection combined with arthroscopic debridement on serum inflammatory factors and therapeutic effects in patients with knee osteoarthritis(KOA).Methods 120 patients with KOA admitted to hospital from January 2014 to January 2016 were randomly divided into study group and control group,with 60 cases in each group.Arthroscopic debridement was performed in both groups,and the study group were added the intra-articular injection of sodium hyaluronate,diprospan and ropivacaine.The levels of serum inflammatory factors[C-reactive protein(CRP),interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α)] were compared between the two groups before and after treatment.The knee pain status[visual analogue score(VAS score)] was recorded after 5 weeks of treatment,and 1 year of follow-up was performed to evaluate joint function(JOA score) and clinical efficacy.Results After 5 weeks of treatment,the levels of CRP,IL-6 and TNF-a in both groups decreased compared with those before treatment(P<0.05 or 0.01),and the decrease in the study group was greater than that in the control group(P<0.01).After 1 year of follow-up,the clinical excellent and good rate in the study group was higher than that in the control group,and difference was statistically significant(P<0.05).At 1 year follow-up,the JOA scores of both groups were higher than those before treatment(P<0.05),and the increase in the study group was greater than that in the control group(P<0.05).Conclusion Arthroscopic debridement combined with drug injection can improve the therapeutic effect of KOA,which is beneficial to improve the recovery of joint function and reduce the level of inflammatory factors in patients.