关节镜清理术结合药物注射治疗膝关节骨性关节炎临床疗效分析

目的 观察关节镜清理术结合药物注射治疗膝关节骨性关节炎的临床疗效.方法 选择2014年6月至2015年1月在我院接受治疗的膝关节骨性关节炎患者156例,根据数字随机表法将其随机分成A、B、C三组,每组各52例.三组均给予关节镜清理术,A组术毕给予生理盐水10 ml注射对照,B组术毕给予玻璃酸钠药物注射,C组在B组基础上再增用复方倍他米松,以及罗哌卡因注射.随访6个月,比较三组患者的临床疗效,治疗前后的HSS评分,以及不同时期的白细胞介素1β(IL-1β)、C反应蛋白(CRP)及类风湿因子(RF)的水平变化.结果 B组和C组的优良率分别为78.85%和94.23%,均明显高于A组的59.62%,差异均有统计学意义(P<0.05),C组的优良率亦明显高于B组,差异有统计学意义(P<0.05);三组治疗后的HSS评分较治疗前均有明显改善,但B、C两组治疗后的HSS评分均明显高于A组,C组治疗后的HSS评分高于B组,差异均有统计学意义(P<0.05);治疗后1个月及治疗后6个月,三组患者的IL-1β、CRP及RF水平较治疗前更低,差异均有统计学意义(P<0.05),C组治疗后1个月及治疗后6个月的IL-1β、CRP及RF水平较A组和B组明显更低,差异均有统计学意义(P<0.05).结论 关节镜清理术结合多类药物注射治疗膝关节骨性关节炎疗效较好,其可有效地抑制炎症反应,值得临床重视.

Clinical efficacy analysis of arthroscopic debridement combined with drug injection in the treatment of knee osteoarthritis

Objective To observe clinical curative effect of arthroscopic debridement combined with drug in-jection in the treatment of knee osteoarthritis. Methods One hundred and fifty-six patients with knee osteoarthritis in our hospital from June 2014 to January 2015 were selected as the research objects, which were randomly divided into group A, B, C according to the random number table, with 52 patients in each group. Three groups were all treated with arthroscopic debridement. Postoperatively, group A was given injection of 10 ml normal saline, and group B was given drug injection of sodium hyaluronate. Group C was given additionally compound betamethasone and ropivacaine injec-tion based on group B. All the patients were followed up for 6 months. The clinical efficacy of different treatment regi-mens, the Henoch-schonlein syndrome (HSS) score of the patients before and after treatment, and levels of interlenkin 1β(IL-1β), C-reactive protein (CRP), rhenmatoid factors (RF) in different periods were compared between the three groups. Results The excellent and good rate of B, C group was 78.85%and 94.23%, which were significantly higher than that in group A of 59.62%(P<0.05). The excellent and good rate of group C was significantly higher than that of group B (P<0.05). After treatment, HSS scores in the three groups were all significantly improved compared with before treatment, but the HSS scores after treatment were significantly higher in group B, C than group A, and also in group C than group B (P<0.05). After 1 month of treatment and 6 months after treatment, the levels of IL-1β, CRP and RF in the three groups were statistically lower than before treatment, and the differences were statistically significant (P<0.05). The levels of CRP, RF and IL-1βwere significantly lower in group C than in group A and group B one month and 6 months after treatment, and the differences were statistically significant (P<0.05). Conclusion The effect of arthroscop-ic debridement combined with multiple drugs injection in the treatment of patients with knee osteoarthritis is better, which can effectively inhibit the inflammatory reaction. It is worthy of clinical attention.