膝关节骨性关节炎注射玻璃酸钠穿刺点选择的临床分析

目的研究膝关节注射玻璃酸钠时穿刺点的选择对中老年骨性关节炎疗效的影响。方法共60例中老年骨性关节炎患者纳入研究。受试者被随机按穿刺点分为髌上囊组、膝眼组及髌旁组,各20例,分析各组注射时视觉模拟评分法(VAS)评分、关节积液抽吸量及当周lysholm评分。结果各组随着治疗时间、lysholm评分呈正相关增长,组间评分比较差异无显著性。髌上囊组及膝眼组在注射4周后,关节积液抽吸人均量分别为(14.75±3.1)ml和(15.0±1.7)ml,与髌旁组的(1.75±0.30)ml相比差异有统计学意义(P<0.05)。注射时VAS疼痛评分结果示:髌上囊组,膝眼组,髌旁组各组失败率分别为15.63%,10.23%及0。前两组与髌旁组评分相比差异有统计学意义(P<0.05)。结论膝关节穿刺点的选择不会影响关节注射的效果。推荐常规髌上囊及膝眼穿刺注射,注射失败首选髌旁注射补救。

Study on clinical selection of puncture points in knee osteoarthritis treated with injection of sodium hyaluronate

Objective To explore the impact of selection of puncture points in knee osteoarthritis treated with injection of sodium hyaluronate.Methods The data of 60 elderly patients with osteoarthritis were analyzed.These patients were randomly divided into suprapatatellar bursa group,knee eye group and parapatellar group,and 20 cases in each group.The VAS scores during injection,the amount of joint effusion sucked and Lysholm scores were analyzed.Results There was positive correlation between therapeutic course and Lysholm scores.There was no significant difference among three groups.Compared with the parapatellar group,the amount per capita of hydrarthrus in the suprapatatellar bursa group and the knee eye group had superior performance.According to VAS scores,the failure rates in three groups were 15.63%,10.23% and 0% respectively.There was significant difference in VAS scores between first two groups and parapatellar group.Conclusion The choice of puncture point will not affect the effect of the injection.The regular puncture ways like suprapatatellar bursa way and knee eye way were recommended.The primary remedy for failure in above-mentioned ways is parapatellar way.