摘要
目的 探讨透明质酸关节腔内注射在半月板损伤关节镜术后应用效果。方法 选择2012年1月~2015年2月在武警浙江总队嘉兴医院骨科收治的半月板损伤患者72例。采用随机数字表将纳入的72例患者分为透明质酸组和对照组,每组各36例。两组患者均在硬膜外麻醉下行关节镜手术治疗,术中根据半月板损伤情况进行半月板修整术或半月板缝合术。透明质酸组术后立即予以关节腔内注射透明质酸钠2.0 m L/次,1次/周,连续4周;对照组除不予以关节腔内注射透明质酸钠外,余治疗同透明质酸组。观察并比较两组患者治疗前和治疗2月后膝关节疼痛评分及膝关节活动度的变化,并进行临床疗效及药物不良反应的观察。结果 治疗2个月后,两组患者膝关节疼痛评分[（1.16±0.25）、（1.95±0.32）分]均较治疗前[（3.14±0.45）、（3.07±0.41）分]明显下降,差异有统计学意义（P〈0.05或P〈0.01）,且透明质酸组下降较对照组更明显,差异有统计学意义（P〈0.05）;两组患者膝关节活动度[（124.32±7.21）°、（109.15±6.25）°]均较治疗前[（55.14±4.27）°、（54.72±4.31）°]明显上升,差异有统计学意义（P〈0.05或P〈0.01）,且透明质酸组上升较对照组更明显,差异有统计学意义（P〈0.05）;透明质酸组患者的临床优良率为94.44%,明显高于对照组（75.00%）,差异有统计学意义（P〈0.05）。透明质酸组1例患者关节注射后出现关节疼痛加剧,经对症处理后好转,未发生其他不良反应。结论 半月板损伤关节镜手术治疗术后应用透明质酸关节腔内注射疗效较显著,可减轻膝关节疼痛评分,有效增加了膝关节活动度,改善膝关节功能,且药物不良反应轻,安全性较好。
Objective To discuss the postoperative curative effect of arthroscopic surgery by hyaluronic acid intra-artic- ular injection on meniscus injury. Methods From January 2012 to February 2015, in Department of Orthopedics, Jiax- ing Hospital of Zhejiang General Corps of Armed Police Forces, 72 patients with meniscus injury were divided into hyaluronic acid group and control group by table of random number, with 36 cases in either group. The patients in two groups were given arthroscopic surgery under epidural anesthesia, and meniscus dressing and meniscal suture according to meniscus injury condition during the operation. The patients in hyaluronic acid group were given 2.0 mL sodium hyaluronate by intra-articular injection each time, once a week for 4 weeks, immediately upon the end of operation; while the patients in control group were given the same medical treatment as hyaluronic acid group except intra-articu- lar sodium hyaluronate injection. The changes of knee pain score and activity of patients in two groups before and after medical treatment 2 months were observed and compared, and the clinical curative effect and drug adverse reaction were observed. Results After medical treatment 2 months, the knee pain scores of patients in two groups [（1.16±0.25）, （1.95±0.32） scores] were obviously declined than those before the treatment [（3.14±0.45）, （3.07±0.41） scores], the dif- ferences were statistically significant （P 〈 0.05 or P 〈 0.01）, and this in hyaluronic acid group was lower than that in control group, the difference was statistically significant （P 〈 0.05）. The knee actively of patients in two groups [（124.32±7.21）°, （109.15±6.25）°] were obviously rose than those before the treatment [（55.14±4.27）°, （54.72±4.31）°], the differences were statistically significant （P 〈 0.05 or P 〈 0.01）, and this in hyaluronic acid group was higher than that in control group; the difference was statistically significant （P 〈 0.05）. Excellent rate of patients in hyaluronic acid group （94.44%） was much higher than that in Control group （75.00%）, the difference was statistically significant （P 〈 0.05）. One case of intensified arthrosis were appeared on patients in hyaluronic acid group, and was improved after medical treatment with no occurrences of other untoward effect. Conclusion The arthroscopic surgery by hyaluronic acid intra-articular injection has significant curative effect on meniscus injury after operation, which can release knee pain score, effectively increase knee activity and improve knee function with light DAR and favorable security.
出处
《中国医药导报》
CAS
2015年第33期117-120,共4页
China Medical Herald
关键词
半月板损伤
关节镜
透明质酸
关节腔内注射
Meniscus injury
Arthroscopic
Hyaluronic acid
Intra-articular injection
