膝关节封闭实验在膝关节骨性关节炎微创术治疗中的应用价值

doi:10.13418/j.issn.1001-165x.2019.04.017

中国临床解剖学杂志 ›› 2019, Vol. 37 ›› Issue (4): 446-449.doi: 10.13418/j.issn.1001-165x.2019.04.017

膝关节封闭实验在膝关节骨性关节炎微创术治疗中的应用价值

胡宗元¹，　张亮²，　张计成¹，　霍玉辉¹，　杨颖¹

1.安国市医院骨科，河北保定 071200； 2.北京积水潭医院矫形科，北京 100035

收稿日期:2019-03-11 出版日期:2019-07-25 发布日期:2019-08-01
通讯作者: 张亮，副主任医师，E-mail: djkedu@qq.com
作者简介:胡宗元（1979-），男，本科，主治医师，研究方向：骨科临床
基金资助:
保定市科技课题项目（16ZF013）

Application value of knee joint closure test in minimally invasive treatment of knee osteoarthritis

HU Zong-yuan¹, ZHANG Liang², ZHANG Ji-cheng¹, HUO Yu-hui¹, YANG Ying¹

1.Orthopaedics Department of Anguo Hospital, Baoding 071200, Heibei Procince; 2.Orthopaedics Department of Beijing Jishuitan Hospital, Beijing 100035, China

Received:2019-03-11 Online:2019-07-25 Published:2019-08-01

摘要/Abstract

摘要： 目的　探讨膝关节封闭实验在膝关节骨性关节炎（KOA）微创术治疗中的应用价值。方法　回顾分析71例行微创治疗的KOA患者的临床资料，根据术前封闭治疗效果分为有效组和无效组，比较两组治疗不同时期VAS评分，观察两组临床疗效，分析两组术后肢体肿胀、关节活动功能及生活质量评分（SF-36）差异。结果　封闭有效组患者封闭后及微创术后1个月VAS评分均显著低于无效组，P＜0.05。有效组患者治疗总有效率、关节Lysholm评分及SF-36评分均优于无效组，P＜0.05。有效组关节肿胀度小于无效组，P＜0.05。有效组患者封闭指数与关节肿胀度呈负相关，与Lysholm评分及SF-36评分均呈正相关，P＜0.05。结论　有效的膝关节封闭能够提高KOA患者行微创手术的临床疗效，降低疼痛程度，改善关节功能及患者术后生活质量。

关键词: 骨性关节炎, 　膝关节, 　封闭治疗, 　VAS评分, 　生活质量

Abstract: Objective　To investigate the application value of block experiment in the treatment of knee osteoarthritis.　Methods　The clinical data of 71 patients with KOA undergoing minimally invasive therapy were retrospectively analyzed. These patients were divided into a valid group and an invalid group according the block effect. The VAS scores at different time were compared in two groups, the clinical efficacy were observed in the two groups. The differences of limb swelling, joint activity function and SF-36 score were analyzed in two groups after operation.　Results　The VAS score in the valid group was significantly lower than in the invalid group after block experiment and 1 month after operation (P<0.05). The clinical efficacy, Lysholm score and SF-36 score in the valid group were better than in the invalid group after treatment(P<0.05) . The degree of joint swelling in the valid group was less than in the invalid group, with statistic difference (P<0.05). The block index in the valid group was negatively correlated with the degree of joint swelling and was positively correlated with the Lysholm score and the SF-36 score(P<0.05). Conclusions Effective block treatment can improve the clinical efficacy of the minimally invasive surgery in KOA patients. It can reduce pain degree, improve the joint function and living quality after operation.

Key words: Osteoarthritis, 　Knee-joint, 　Block treatment, 　VAS score, 　Living quality

中图分类号:

R687.4

胡宗元, 张亮, 张计成, 霍玉辉, 杨颖. 膝关节封闭实验在膝关节骨性关节炎微创术治疗中的应用价值[J]. 中国临床解剖学杂志, 2019, 37(4): 446-449.

HU Zong-yuan, ZHANG Liang, ZHANG Ji-cheng, HUO Yu-hui, YANG Ying. Application value of knee joint closure test in minimally invasive treatment of knee osteoarthritis[J]. Chinese Journal of Clinical Anatomy, 2019, 37(4): 446-449.

参考文献 16

[1]	Park YB, Ha CW, Lee CH, et al. Cartilage regeneration in osteoarthritic patients by a composite of allogeneic umbilical cord blood-derived mesenchymal stem cells and hyaluronate hydrogel: results from a clinical trial for safety and proof-of-concept with 7 years of extended follow-up[J]. Stem Cells Transl Med, 2017, 6(2): 613-621.
[2]	Englund M, Turkiewicz A. Osteoarthritis increasingly common public disease[J]. Lakartidningen, 2014, 111(21): 930-931.
[3]	李冉, 白岚, 李树祝. 膝关节骨性关节炎中医治疗模式研究进展[J]. 现代中西医结合杂志, 2014, 23(1): 104-107.
[4]	尹向辉, 孙健, 裴秋艳, 等. 关节镜清理术序贯中药组方熏洗治疗老年膝骨性关节炎49例[J]. 中国药业, 2015, 24(6): 73-74, 75.
[5]	任树军, 任明辉, 王墉琦, 等. 局部封闭配合针刀治疗痰湿阻滞型膝关节滑膜皱襞综合征48例[J]. 中国中医骨伤科杂志, 2016, 24(12): 38-41.
[6]	中华医学会骨科学分会关节外科学组. 骨关节炎诊疗指南(2018年版)[J]. 中华骨科杂志, 2018, 38(12): 705-715.
[7]	Cruz-Montecinos C, Flores-Cartes R, Montt-Rodriguez A, et al. Changes in co-contraction during stair descent after manual therapy protocol in knee osteoarthritis: a pilot, single-blind, randomized study[J]. J Bodyw Mov Ther, 2016, 20(4): 740-747.
[8]	肖勋刚, 鲁世金, 成明华, 等. 关节镜辅助下微骨折技术联合玻璃酸钠关节腔注射治疗膝关节骨性关节炎[J]. 广东医学, 2015, 36(10): 1512-1514.
[9]	顾始伟, 赵思桥, 夏涛. 玻璃酸钠联合封闭治疗膝骨性关节炎伴膝关节内侧疼痛的临床回顾性研究[J]. 中国骨与关节损伤杂志, 2016, 31(6): 57-58.
[10]	金成辉. 关节镜清理配合腔内注射玻璃酸钠治疗膝关节骨性关节炎临床疗效观察[J]. 河北医学, 2014, 20(12): 2027-2029.
[11]	赵依娜, 周江涛. 依托考昔结合功能训练治疗膝骨性关节炎疗效及对炎性调节因子的影响[J]. 中国全科医学, 2017, 20(S1): 43-45.
[12]	Behery O, Siston RA, Harris JD, et al. Treatment of cartilage defects of the knee: expanding on the existing algorithm[J]. Clin J Sport Med, 2014, 24(1): 21-30.
[13]	Mootanah R, Imhauser CW, Reisse F, et al. Development and validation of a computational model of the knee joint for the evaluation of surgical treatments for osteoarthritis[J]. Comput Methods Biomech Biomed Engin, 2014, 17(13): 1502-1517.
[14]	沈文革, 吕永强, 祁峰, 等. 关节镜下关节清理加灌洗治疗慢性膝关节骨性关节炎的疗效分析[J]. 中华全科医学, 2014, 12(8): 1251-1253.
[15]	王玮, 庄小强, 白宇, 等. 局麻下行膝关节关节镜手术的应用体会[J]. 中国内镜杂志, 2015, 21(12): 1327-1330.
[16]	Albertoni Giraldes AL, Salomão R, Leal PD, et al. Effect of intravenous lidocaine combined with amitriptyline on pain intensity, clinical manifestations and the concentrations of IL-1, IL-6 and IL-8 in patients with fibromyalgia: A randomized double-blind study[J]. Int J Rheum Dis, 2016, 19(10): 946-953.

膝关节封闭实验在膝关节骨性关节炎微创术治疗中的应用价值

Application value of knee joint closure test in minimally invasive treatment of knee osteoarthritis

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