局部封闭治疗膝关节骨性关节炎疼痛46例

目的:探讨膝关节骨性关节炎疼痛的局部封闭治疗效果。方法:2%利多卡因注射液5ml,曲安奈德注射液10mg(1ml),维生素B12注射液500ug(1mL)复和液,注射膝关节关节囊内外侧外面,用药量5-7ml。结果:46例患者经过以上方法治疗后,疼痛明显减轻,无其他不良反映,3例经1次治疗7天后疼痛再发,但较第1次减轻。再次用同样方法治疗,疼痛症状明显缓解。结论:局部封闭对膝关节骨性关节炎发作期的疼痛具有较好治疗效果。     

菱形阻滞加腔内注射透明质酸钠治疗膝关节骨性关节炎

目的：对比观察菱形阻滞加关节腔内注射透明质酸钠（SH）和单纯透明质酸钠注射治疗膝关节骨性关节炎疗效。方法：将64例早中期膝关节骨性关节炎病人随机分为2组,每组32例。治疗组用0.2%利多卡因阻滞液行膝关节菱形阻滞后,再注入玻璃酸钠2.5 mL,每周1次,共5次。对照组用玻璃酸钠膝关节腔内注射2.5 mL,每周1次,共5次。结果：治疗第5周和治疗后6月膝关节功能评分结果显示,两组膝关节评分均较治疗前显著升高（P〈0.001）,但治疗组的评分值明显高于对照组（P〈0.001）;治疗组总有效率96.87%,明显高于对照组78.13%（P〈0.001）。结论：关节内注射SH配合菱形阻滞治疗膝骨性关节炎的临床疗效优于单纯注射SH者。     

施沛特治疗膝关节创伤性骨关节炎的疗效观察

目的　观察施沛特对膝关节创伤性关节炎的治疗效果。方法　对 3 0例膝关节创伤性关节炎患者每周 1次膝关节腔内注射施沛特2 0ml,连续 5次 ,对治疗前后进行评分。结果　 3 0例中获缓解 10例 ,显效 12例 ,有效 6例 ,无效 2例 ,总有效率 93 .3 %。结论　施沛特对膝关节创伤性关节炎有确切疗效     

曲安奈德注射液治疗瘢痕疙瘩163例疗效观察

目的观察曲安奈德注射液治疗瘢痕疙瘩的疗效。方法用曲安奈德注射液1ml加入2％利多卡因注射液1ml混匀后在瘢痕内分点蠕动式加压注射,直至皮损全覆盖。于治疗后第1、2、3月观察并记录患者症状、体征的改善情况及不良反应。随访1年,观察复发情况。结果在治疗后第1月总有效率为48．46％,第2月总有效率为80．37％,第3月总有效率为90．18％;有9例女性患者出现月经提前的不良反应,停药后自然恢复;仅3例复发。结论曲安奈德注射液治疗瘢痕疙瘩起效快、疗程短、疗效好、不良反应少,复发率低。     

康柏西普联合曲安奈德玻璃体内注射治疗黄斑水肿疗效

目的研究康柏西普联合曲安奈德玻璃体内注射治疗黄斑水肿疗效。方法经光学相干断层扫描和眼底血管荧光造影检查确诊糖尿病黄斑水肿患者45例,共85只眼,对照组采用单纯曲安奈德玻璃体内注射治疗,治疗组采用康柏西普联合曲安奈德治疗,分别对治疗前和治疗后1、3个月患者光学相干断层扫描、矫正视力和眼压等进行观察,用SPASS 17.0软件进行统计学分析。结果 2种方法治疗3个月,患者视力都有所提高,且2种药物联合使用对光学相干断层扫描和矫正视力的改善效果更为显著。结论康柏西普联合曲安奈德玻璃体内注射是治疗糖尿病黄斑水肿的有效方法,可以提高治疗的安全性和有效性。     

X线引导关节腔内脉冲射频联合玻璃酸钠注射对慢性难治性膝骨关节炎的疗效观察

目的 评估X线引导膝关节腔内脉冲射频联合玻璃酸钠注射对慢性难治性膝骨关节炎的疗效.方法 2017年6月至2019年6月门诊收治保守治疗无效的慢性难治性膝关节骨性关节炎患者62例(72侧膝关节),经X线引导行膝关节腔内脉冲射频联合玻璃酸钠注射治疗.通过视觉模拟评分量表(VAS)评估治疗前和治疗后1周、1个月、6个月和12...     

白介素1受体拮抗蛋白间接体内转基因对兔骨性关节炎的抑制作用

目的　探讨IL 1受体拮抗蛋白 (IL 1Ra)间接体内转基因对兔骨性关节炎临床表现及关节软骨破坏的抑制作用。方法　 30只新西兰大白兔(8月龄 ,雌性 ,体重 2 5～ 3 0kg)随机分成 3组 ,左膝关节部分滑膜切除 ,分离并培养滑膜成纤维细胞。用携带标记基因或IL 1Ra基因的逆转录病毒分别转染从第 2组或第 3组兔膝关节分离出来的滑膜细胞。采用兔右膝关节前交叉韧带横断术 (ACLT)建立骨关节炎模型。把自体滑膜细胞回输第 1组兔右膝关节腔内 ,把转染标记基因或IL 1Ra基因的自体滑膜细胞回输第 2组或第 3组兔右膝关节腔内。2、4周后 ,用ELISA方法检测右膝关节液中IL 1Ra水平。用膝关节临床评估级别对转IL 1Ra基因组和对照组膝关节局部疼痛刺激反应、步态改变、关节肿胀和活动范围进行评估。根据墨汁软骨表面着色和软骨组织病理改变情况对软骨破坏程度进行分级。结果　转IL 1Ra基因组 (第 3组)兔膝关节液中IL 1Ra水平明显升高 ,在基因转入关节腔后第 2周时为 2 0 6± 1 8ng/ml,第 4周时为 4 82± 0 5 2ng/ml;而 2、4周时 ,对照组(第 1、2组 )关节液中IL 1Ra水平均很低 ;转IL 1Ra基因组膝骨性关节炎的临床表现及膝关节软骨破坏程度 (大体及组织学观察 )均明显轻于对照组。结论　IL 1Ra间接体内转基因治疗能使关节     

曲安奈德治疗膝骨关节炎210例

在我国 ,骨关节炎 (ＯＡ )发病率达 3%～9% [1 2 ] ,多为 5 0岁以上 ,是一种严重影响生活质量和社会劳动能力的常见病。 1998年 1月～ 2 0 0 0年12月 ,我们用曲安奈德等药物行膝关节腔内注射 ,治疗膝ＯＡ 2 10例 ,取得了满意的疗效。1　临床资料1 1　一般情况　男 4 3例 ,女 167例 ;年龄 4 5～ 79岁 ,平均 62岁。病程 7ｄ～ 2 0年 ,平均 4 6年。膝Ｘ线片检查 :均有膝关节骨质增生 ,关节间隙变窄。1 2　诊断方法[3 ] 　采用美国Ａｔ ｍａｎ等提出的膝骨关节炎诊断标准 ,即膝关节痛加骨赘再加以下至少 1条即可诊断 :( 1)年龄 5 0岁以上 ;( 2 …     

理疗联合关节腔内给药治疗膝骨性关节炎效果观察

目的：观察理疗联合关节腔内注射玻璃酸钠治疗膝骨性关节炎的疗效。方法：选择膝骨性关节炎50例,随机分为观察组和对照组各25例。对照组给予关节腔内注射玻璃酸钠,观察组在此基础上配合超短波治疗和中频电刺激治疗。疗程均为4周,观察并比较两组膝关节功能评分改善情况。结果：两组膝关节肿胀、行走疼痛得分及总分均显著或非常显著高于治疗前（P〈0.05,P〈0.01）;两组治疗后比较,观察组膝关节行走疼痛、上下楼梯疼痛得分及总分均显著或非常显著高于对照组（P〈0.05,P〈0.01）。结论：关节腔内注射玻璃酸钠联合物理治疗膝骨性关节炎效果优于单纯关节腔内注射玻璃酸钠治疗。     

综合治疗中老年膝关节骨性关节炎56例临床观察

中老年膝关节骨性关节炎亦称膝关节增生性关节炎,是骨科门诊最常见的疾病之一。既往采用口服消炎镇痛及活血化瘀类药等保守治疗,效果欠佳。2006-01～2008-12,我院对中老年患者采用针刀松解＋关节腔冲洗＋腔内注射玻璃酸钠综合治疗56例,取得良好效果,现报道如下。     

不同方法治疗成人分泌性中耳炎疗效对比分析

目的探讨不同方式治疗成人分泌性中耳炎的临床效果。方法将123例分泌性中耳炎患者随机分为3组,Ⅰ组：地塞米松5mg＋盐酸氨溴索15mg,鼓室内注射;Ⅱ组：曲安奈德40mg＋盐酸氨溴索15mg,鼓室内注射;Ⅲ组：鼓膜置管引流。比较3组的治疗效果、并发症及治疗后不同时间段气导平均听阈。结果治疗后3个月,Ⅱ、Ⅲ组治愈率及总有效率较I组均显著升高（P〈0.05）,Ⅲ组并发症发生率明显高于Ⅰ、Ⅱ组（P〈0.05）。3组患者治疗后各时间段气导平均听阈均显著改善,其中Ⅱ、Ⅲ组各时间段显著优于Ⅰ组（P〈0.05）。结论鼓室内注射曲安奈德和盐酸氨溴索治疗分泌性中耳炎疗效好,并发症少。     

A phase I/IIa study on intra-articular injection of holmium-166-chitosan complex for the treatment of knee synovitis of rheumatoid arthritis

Previous animal studies have established that the intra-articular injection of holmium-166-chitosan complex (DW-166HC) causes effective necrosis of the inflamed synovium with litle leakage of radioactivity from the injected joint. Based on these findings, we conducted a phase I/IIa study to examine the biodistribution of DW-166HC and to assess the safety of DW-166HC for the treatment of knee synovitis in patients with rheumatoid arthritis (RA). A total of 16 patients [1 man, 15 women; median age 49 (range 36-65) years] who had RA knee synovitis refractory to disease-modifying anti-rheumatic drug treatments of > 3 months' duration were randomly assigned to three treatment groups with different radiation doses of DW-166HC: 370 MBq (n = 6), 555 MBq (n = 5) and 740 MBq (n = 5). In each treatment group, blood and urine radioactivity were analysed by beta counter and biodistribution of the injected DW-166HC was evaluated using a gamma scan camera. Clinical assessment was done according to three variables (evaluation method): knee joint pain (visual analogue scale), range of motion (goniometry) and joint swelling (circumference of knee joint). The duration of follow-up observation was 3 months. Following the intra-articular injection of DW-166HC, the blood radioactivity was little changed from the baseline measurement and the accumulated radioactivity excreted in urine was minimal. Gamma scan study indicated that most of the injected radiochemical was localized within the injected joint cavity, and the extra-articular leakage was negligible at 24 h after the injection: brain, 0.3%; lung, 0.6%; abdomen, 0.7%; and pelvis, 0.8%. Major adverse events were transient post-injection knee joint pain and swelling. These results suggest that DW-166HC might be a safe agent for radiation synovectomy, particularly for the treatment of knee synovitis of RA, and further trials in a larger patient population are warranted to evaluate the therapeutic efficacy of DW-166HC.     

Fatal complications of intramuscular and intra-articular injections

Summary Four fatalities related to intramuscular and intra-articular injections are reported. In two of these cases aStaphylococcus aureus sepsis developed, as a consequence of injections into the left hip joint in one and in the lateral upper quadrant of the gluteal region in the other. The intra-articular injection of triamcinolone produced severe pain, but no marked signs of purulent arthritis were seen at autopsy, probably because of the anti-inflammatory effect of the corticosteroid. A cutaneous infection was seen in the gluteal region of the other patient, but no apparent abscess formation. In another case of intra-articular injection, purulent knee joint arthritis developed after an injection of glucosaminoglycan. The patient died of renal insufficiency, which was probably connected with the treatment of the arthritis with tobramycin and cefuroxim. The fourth case was that of a mentally ill patient who suffered sudden cardiac arrest after an intramuscular injection of chlorpromazine, but with no apparent signs of an anaphylactic reaction. It is suggested that vasodilatation and drop in blood pressure caused by the chlorpromazine could have had some effect, while cardiotoxicity of other psychotropic drugs with which he had been treated cannot be ruled out.     

A phase I/IIa study on intra-articular injection of holmium-166-chitosan complex for the treatment of knee synovitis of rheumatoid arthritis

Previous animal studies have established that the intra-articular injection of holmium-166-chitosan complex (DW-166HC) causes effective necrosis of the inflamed synovium with little leakage of radioactivity from the injected joint. Based on these findings, we conducted a phase I/IIa study to examine the biodistribution of DW-166HC and to assess the safety of DW-166HC for the treatment of knee synovitis in patients with rheumatoid arthritis (RA). A total of 16 patients [1 man, 15 women; median age 49 (range 36-65) years] who had RA knee synovitis refractory to disease-modifying antirheumatic drug treatments of >3 months' duration were randomly assigned to three treatment groups with different radiation doses of DW-166HC: 370 MBq (n=6), 555 MBq (n=5) and 740 MBq (n=5). In each treatment group, blood and urine radioactivity were analysed by beta counter and biodistribution of the injected DW-166HC was evaluated using a gamma scan camera. Clinical assessment was done according to three variables (evaluation method): knee joint pain (visual analogue scale), range of motion (goniometry) and joint swelling (circumference of knee joint). The duration of follow-up observation was 3 months. Following the intra-articular injection of DW-166HC, the blood radioactivity was little changed from the baseline measurement and the accumulated radioactivity excreted in urine was minimal. Gamma scan study indicated that most of the injected radiochemical was localized within the injected joint cavity, and the extra-articular leakage was negligible at 24 h after the injection: brain, 0.3%; lung, 0.6%; abdomen, 0.7%; and pelvis, 0.8%. Major adverse events were transient post-injection knee joint pain and swelling. These results suggest that DW-166HC might be a safe agent for radiation synovectomy, particularly for the treatment of knee synovitis of RA, and further trials in a larger patient population are warranted to evaluate the therapeutic efficacy of DW-166HC.     

醋酸曲安奈德益康唑乳膏治疗外耳道炎性反应的疗效

 目的 探讨在耳内镜下向外耳道内注入醋酸曲安奈德益康唑乳膏治疗外耳道炎性反应的临床疗效。方法 选取解放军总医院第三医学中心2015-01至2018-10门诊诊治的404例外耳道疾患患者(双耳63例),共467耳,其中真菌性外耳道炎424耳,外耳道疖肿(未破溃)43耳。将两种疾病患者分别随机分为试验组和对照组,真菌性外耳道炎每组181例,外耳道疖肿患者每组21例,试验组均予醋酸曲安奈德益康唑乳膏注入外耳道治疗,对照组中真菌性外耳道炎予制霉菌素片粉末喷洒,外耳道疖肿予红霉素软膏涂抹,治疗1周,随诊2～3周,对比观察治疗后疗效。结果 真菌性外耳道炎试验组总有效率为92.5%,对照组为67%,试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05);外耳道试验组总有效率为90.5%,对照组为57.1%,试验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论 耳内镜下彻底清理外耳道,并用醋酸曲安奈德益康唑乳膏注满外耳道,治疗外耳道炎性反应,疗效确切,恢复快,值得临床推广。     

关节镜下关节清理术结合功能锻炼治疗膝骨关节炎

目的探讨膝骨关节炎(KOA)患者在关节清理术后配合玻璃酸钠关节内注射及早期进行功能锻炼对膝关节功能的影响。方法 109例患者共146膝,分为A、B、C三组,A组仅进行关节镜下关节清理术、B组在关节清理术后配合关节腔玻璃酸钠注射治疗,C组关节清理术后除进行玻璃酸钠注射外,配合膝关节功能锻炼。三组患者在治疗前、治疗后2个月及6个月分别采用Lysholm评分对患者进行膝关节功能评分。结果三组患者关节疼痛程度及膝关节功能较治疗前明显改善,治疗后2个月,B、C两组Lysholm评分优于A组,B、C两组均显著优于A组,C组又优于B组,差异均有统计学意义(P<0.05);治疗后6个月,C组疗效优于A、B两组,差异具有统计学意义(P<0.05)。结论膝关节清理术后配合玻璃酸钠关节内注射及早期开展功能锻炼可以明显提高老年骨关节炎的治疗效果。     

An intraarticular fibroma of the tendon sheath in the knee joint

Fibromas that usually occur in the tendon sheaths of the wrist and hand are extremely rare in intra-articular locations. Only five such cases in the knee joint have been reported so far. This is a case report of an intra-articular fibroma of the tendon sheath of the knee joint arising adjacent to posterior cruciate ligament (PCL). Magnetic resonance imaging (MRI) revealed a well-defined intra-articular lesion in the region of the intercondylar notch of the femur behind the PCL. The mass was excised by arthrotomy. Histopathological study confirmed the diagnosis.     

高效液相色谱法同时测定醋酸曲安奈德溶液中醋酸曲安奈德及曲安奈德的含量

目的建立高效液相色谱法同时测定醋酸曲安奈德溶液中醋酸曲安奈德及曲安奈德的含量。方法采用美国AgilentZORBAX SB-C18色谱柱,以甲醇-水（68：32）为流动相。检测波长为240nm,流速为1ml/min。结果醋酸曲安奈德和曲安奈德在10min内完全分离,两者均在0.1～100mg/L范围内线性关系良好,日内精密度和日间精密度的RSD均小于2%（n=5）。结论本法准确、可靠、重复性好,可有效控制醋酸曲安奈德溶液的质量。     

局封加美宝疤痕平治疗不稳定阶段瘢痕的疗效分析

目的：探讨美宝疤痕平对不稳定阶段瘢痕疙瘩局封治疗的疗效。方法：对60例瘢痕疙瘩经曲安缩松局封后外涂美宝疤痕平。结果：一年后治愈率达76．7％，痊愈的显效率达90％。结论：美宝疤痕平与曲安缩松局封联合对防治不稳定阶段瘢痕疙瘩增生、止痒止痛有较好的疗效。