中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
6期
555-559
,共5页
顾海峰%毕擎%孟可馨%曹力%赵晨%章水均
顧海峰%畢擎%孟可馨%曹力%趙晨%章水均
고해봉%필경%맹가형%조력%조신%장수균
膝关节%关节炎%关节镜
膝關節%關節炎%關節鏡
슬관절%관절염%관절경
Knee joint%Arthritis%Arthroscopes
目的 比较关节镜下360°去神经化与膝关节常规清理术治疗膝关节骨关节炎的疗效. 方法 收集2006年5月-2011年5月共90例骨关节炎患者,5例患者失随访,最终纳入85例,按入院尾数单双号分为两组,A组42例接受关节镜下关节清理术,B组43例接受关节镜下关节清理加360°去神经化,其中创伤性关节炎30例,退行性关节炎55例;男34例,女51例;平均年龄63岁(52~73岁).比较两组患者术前、术后西安大略和麦克马斯特大学骨关节炎指数评分(Western Ontario and McMaster University Osteoarthritis Index,WOMAC)、健康调查简表(the MOSitem short from health survey,SF-36)及视觉模拟评分(visual analogue scale,VAS). 结果 术后两组WOMAC评分、SF-36评分较术前均有改善,B组术后6,12,24个月WOMAC评分的平均值分别为81.0,78.5,82.4,低于A组的86.8,83.8,91.7;B组术后6,12,24个月SF-36评分的平均值分别为47.4,46.3,44.4,高于A组的43.9,41.4,39.5(P <0.05).B组术后1周的VAS评分1.6低于A组的2.6(P <0.05).两组术后关节肿胀的发生差异无统计学意义(P>0.05). 结论 根据膝关节骨关节炎的受累范围、膝关节腔内滑膜神经分布的特点,360°去神经化可以进行全方位多间室的彻底清理,并尽可能多地去除膝关节腔内滑膜的神经支配,在术后症状改善情况及维持时间上均较常规清理术疗效显著.
目的 比較關節鏡下360°去神經化與膝關節常規清理術治療膝關節骨關節炎的療效. 方法 收集2006年5月-2011年5月共90例骨關節炎患者,5例患者失隨訪,最終納入85例,按入院尾數單雙號分為兩組,A組42例接受關節鏡下關節清理術,B組43例接受關節鏡下關節清理加360°去神經化,其中創傷性關節炎30例,退行性關節炎55例;男34例,女51例;平均年齡63歲(52~73歲).比較兩組患者術前、術後西安大略和麥剋馬斯特大學骨關節炎指數評分(Western Ontario and McMaster University Osteoarthritis Index,WOMAC)、健康調查簡錶(the MOSitem short from health survey,SF-36)及視覺模擬評分(visual analogue scale,VAS). 結果 術後兩組WOMAC評分、SF-36評分較術前均有改善,B組術後6,12,24箇月WOMAC評分的平均值分彆為81.0,78.5,82.4,低于A組的86.8,83.8,91.7;B組術後6,12,24箇月SF-36評分的平均值分彆為47.4,46.3,44.4,高于A組的43.9,41.4,39.5(P <0.05).B組術後1週的VAS評分1.6低于A組的2.6(P <0.05).兩組術後關節腫脹的髮生差異無統計學意義(P>0.05). 結論 根據膝關節骨關節炎的受纍範圍、膝關節腔內滑膜神經分佈的特點,360°去神經化可以進行全方位多間室的徹底清理,併儘可能多地去除膝關節腔內滑膜的神經支配,在術後癥狀改善情況及維持時間上均較常規清理術療效顯著.
목적 비교관절경하360°거신경화여슬관절상규청리술치료슬관절골관절염적료효. 방법 수집2006년5월-2011년5월공90례골관절염환자,5례환자실수방,최종납입85례,안입원미수단쌍호분위량조,A조42례접수관절경하관절청리술,B조43례접수관절경하관절청리가360°거신경화,기중창상성관절염30례,퇴행성관절염55례;남34례,녀51례;평균년령63세(52~73세).비교량조환자술전、술후서안대략화맥극마사특대학골관절염지수평분(Western Ontario and McMaster University Osteoarthritis Index,WOMAC)、건강조사간표(the MOSitem short from health survey,SF-36)급시각모의평분(visual analogue scale,VAS). 결과 술후량조WOMAC평분、SF-36평분교술전균유개선,B조술후6,12,24개월WOMAC평분적평균치분별위81.0,78.5,82.4,저우A조적86.8,83.8,91.7;B조술후6,12,24개월SF-36평분적평균치분별위47.4,46.3,44.4,고우A조적43.9,41.4,39.5(P <0.05).B조술후1주적VAS평분1.6저우A조적2.6(P <0.05).량조술후관절종창적발생차이무통계학의의(P>0.05). 결론 근거슬관절골관절염적수루범위、슬관절강내활막신경분포적특점,360°거신경화가이진행전방위다간실적철저청리,병진가능다지거제슬관절강내활막적신경지배,재술후증상개선정황급유지시간상균교상규청리술료효현저.
Objective To compare the curative effect of 360° arthroscopic denervation and routine arthroscopic debridement in treatment of knee osteoarthritis.Methods A total of 85 patients were included in the study after excluding the 5 follow-up dropout among the 90 patients with knee osteoarthritis treated between May 2006 and May 2011.Subsequently,the odd and even quality of the mantissa of admission number was used to determine the groups:Group A,42 patients underwent routine arthroscopic debridement; Group B,43 patients underwent arthroscopic debridement plus 360 degree denervation.Traumatic and degenerative arthritis occurred in 30 and 55 patients respectively.There were 34 male and 51 female patients whose mean age was 63 years (range,52-73 years).Western Ontario and McMaster University Osteoarthritis Index (WOMAC),MOS item short from health survey (SF-36),and visual analogue score (VAS) were compared between the two groups before and after operation.Results WOMAC score and SF-36 score of the two groups improved after surgery.At postoperative 6 months,12 months,and 24 months,WOMAC in Group B scored 81.0,78.5,and 82.4 respectively,lower than 86.8,83.8,and 91.7 in Group A (P < 0.05) ; SF-36 in group B scored 47.4,46.3,and 44.4 respectively,higher than 43.9,41.4,and 39.5 in group A (P < 0.05).At postoperative 1 week,VAS of group B was 1.6 points,lower than 2.6 points in group A (P < 0.05).There was no statistical difference between the two groups in postoperative swelling of joint (P > 0.05).Conclusions According to the area involved in knee osteoarthritis and characteristics of innervation of knee joint synovium,arthroscopic 360° denervation provides thorough debridement and removes as many innervation of knee joint synovium.Arthroscopic 360° denervation is superior to the routine arthroscopic debridement in improvement and duration of the symptoms.