CAJ | 학술논문

目的：探讨输液式关节冲洗并透明质酸钠针对双膝骨关节炎患者步态时空参数及下肢关节活动的影响。方法选择2012年5月~2014年1月于自贡市第一人民医院诊治的双膝骨关节炎患者31例，分为实验组(17例)及对照组(14例)。对照组给予常规治疗和透明质酸钠针注射，实验组在对照组基础上给予输液式关节冲洗，治疗5周，治疗前后对患者进行步态分析，对步频、步速、步态周期、步幅等时间距离参数及患者下肢髋膝踝大关节步态中活动角度进行测量，评定治疗效果。结果治疗后两组患者步频、步幅、步速[对照组：(78.04±8.78)步/min、(115.38±7.79)cm、(0.76±0.16)m/s；实验组：(91.13±13.60)步/min、(122.25±7.47)cm、(0.95±0.24m/s)]较治疗前[对照组：(72.28±7.49)步/min、(110.17±10.13)cm、(0.70±0.17)m/s；实验组：(70.89±9.18)步/min、(112.37±8.15)cm，(0.68±0.11)m/s]提高，步态周期[对照组为(1.55±0.23)s，实验组为(1.34±0.30)s]较治疗前[对照组为(1.61±0.26)s，实验组为(1.68±0.21)s]缩短，差异均有统计学意义(P<0.05或P<0.01)。治疗后实验组患者的步频、步态周期、步幅、步速均较对照组有明显改善，差异均有统计学意义(P<0.05或P<0.01)。同时足跟着地期下肢髋、膝、踝角度[(25.8±2.5)o、(-1.3±0.2)o、(-4.5±2.6o)]及支撑期下肢髋、膝、踝角度[(30.2±3.6)o、(8.7±2.6)o、(-7.2±2.9)o]较对照组[(25.8±2.5)o、(1.9±0.2)o、(-7.4±3.1)o；(29.6±2.2)o、(7.3±2.9)o、(-11.3±2.9)o]明显改善，差异均有统计学意义(P<0.05或P<0.01)。结论输液式关节冲洗及透明质酸钠针关节腔内注射能够有效地改善膝关节骨性关节炎患者的步态，值得推广应用。
목적：탐토수액식관절충세병투명질산납침대쌍슬골관절염환자보태시공삼수급하지관절활동적영향。방법선택2012년5월~2014년1월우자공시제일인민의원진치적쌍슬골관절염환자31례，분위실험조(17례)급대조조(14례)。대조조급여상규치료화투명질산납침주사，실험조재대조조기출상급여수액식관절충세，치료5주，치료전후대환자진행보태분석，대보빈、보속、보태주기、보폭등시간거리삼수급환자하지관슬과대관절보태중활동각도진행측량，평정치료효과。결과치료후량조환자보빈、보폭、보속[대조조：(78.04±8.78)보/min、(115.38±7.79)cm、(0.76±0.16)m/s；실험조：(91.13±13.60)보/min、(122.25±7.47)cm、(0.95±0.24m/s)]교치료전[대조조：(72.28±7.49)보/min、(110.17±10.13)cm、(0.70±0.17)m/s；실험조：(70.89±9.18)보/min、(112.37±8.15)cm，(0.68±0.11)m/s]제고，보태주기[대조조위(1.55±0.23)s，실험조위(1.34±0.30)s]교치료전[대조조위(1.61±0.26)s，실험조위(1.68±0.21)s]축단，차이균유통계학의의(P<0.05혹P<0.01)。치료후실험조환자적보빈、보태주기、보폭、보속균교대조조유명현개선，차이균유통계학의의(P<0.05혹P<0.01)。동시족근착지기하지관、슬、과각도[(25.8±2.5)o、(-1.3±0.2)o、(-4.5±2.6o)]급지탱기하지관、슬、과각도[(30.2±3.6)o、(8.7±2.6)o、(-7.2±2.9)o]교대조조[(25.8±2.5)o、(1.9±0.2)o、(-7.4±3.1)o；(29.6±2.2)o、(7.3±2.9)o、(-11.3±2.9)o]명현개선，차이균유통계학의의(P<0.05혹P<0.01)。결론수액식관절충세급투명질산납침관절강내주사능구유효지개선슬관절골성관절염환자적보태，치득추엄응용。
Objective To study the effects of continuous closed drainage on gait time distance parameter of knee os-teoarthritis (KOA) patients. Methods From May 2012 to January 2014, in Zigong First People's Hospital, 31 KOA pa-tients were selected and divided into two groups, control group (14 cases) and experiment group (17 cases). The control group were given conventional therapy and Sodium Hyaluronate drainage, the experiment group were given continuous closed drainage on the basis of the control group. After treating 5 weeks, time distance parameter such as gait analysis, stride frequency, gait speed, gait cycle, stride, and kinematics analysis of major lower limb joint were measured, the treatment effect was evaluated. Results After the treatment, stride frequency, stride, gait speed of two groups [control group: (78.04±8.78) gait/min, (115.38±7.79) cm, (0.76±0.16) m/s; experiment group: (91.13±13.60) gait/min, (122.25±7.47) cm, (0.95±0.24)m/s] were higher than those before the treatment [control group: (72.28±7.49) gait/min, (110.17±10.13) cm, (0.70±0.17) m/s; experiment group: (70.89±9.18) gait/min, (112.37±8.15) cm, (0.68±0.11) m/s], the differ-ences were statistically significant (P< 0.05 or P< 0.01). After the treatment, stride frequency, gait speed, gait cycle, stride in experiment group were better than those in control group, the differences were statistically significant (P <0.05 or P<0.01). At the same time, the angles of hip, keen and ankle joint at the heel land phase [(25.8±2.5)o, (-1.3±0.2)o, (-4.5±2.6o)] and the angles of hip, keen and ankle joint at the stand phase [(30.2±3.6)o, (8.7±2.6)o, (-7.2±2.9)o] significantly proved than control group after treatment [(25.8±2.5)o, (1.9±0.2)o, (7.4±3.1)o;(29.6±2.2)o, (7.3±2.9)o, (-11.3±2.8)o], the differences were statistically significant (P < 0.05 or P < 0.01). Conclusion The treatment of continuous closed drainage and Sodium Hyaluronate drainage are benefit for the gait of KOA patient, it is worth of popularization and application.