他克莫司预防老年髋关节置换术后瘢痕粘连的效果观察

目的:探讨他克莫司联合医用交联高分子透明质酸钠凝胶预防老年髋关节置换术后瘢痕粘连的效果.方法:选取2018年1月至2020年12月某院收治的84例全髋关节置换术治疗者为对象,随机分为2组,各42例.对照组给予医用交联高分子透明质酸钠凝胶,观察组在对照组基础上给予局部应用他克莫司.比较2组患者术后髋关节功能、疼痛评分及血...

Effect of tacrolimus combined with medical crosslinked polymer sodium hyaluronate gel on prevention of scar adhesion after hip replacement in elderly patients

OBJECTIVE To study the effect of tacrolimus combined with medical crosslinked polymer sodium hyaluronate gel on prevention of scar adhesion after hip replacement in elderly patients.METHODS 84 patients with total hip replacement in our hospital from January 2018 to December 2020 were randomly divided into two groups, 42 cases in each group.The control group was treated with medical crosslinked polymer sodium hyaluronate gel, and the observation group was given topical tacrolimus on the basis of the control group.The hip function, pain score, serum interleukin-4(IL-4) and transforming growth factor were compared between the two groups- β(TGF- β) level.The incidence of adverse reactions in the two groups were observed.RESULTS There was no significant difference in operation related indexes between the two groups(P>0.05).7 days, 1 month and 6 months after operation, the score of Harris was higher in the observation group than that of the control group[(75.88±5.53)/(73.25±5.86), (89.21±6.03)/(83.08±4.69), (90.22±6.25)/(85.46±5.16)], There were significant differences(all P<0.05).One month and six months after operation, the score of VAS score was higher in the observation group than that of the control group[(3.76±1.02)/(4.25±1.09), (2.14±0.62)/(3.21±0.87)], the differences were significant(all P<0.05).7 days and 1 month after operation, the serum levels of IL-4 and TGF- β in the observation group were higher than those in the control group They were lower than those in the control group(P<0.01); The incidence of adverse reactions was 4.76% in the control group and 7.14% in the observation group.There was no significant difference between the two groups(P=0.645).CONCLUSION Intraarticular application of tacrolimus combined with medical crosslinked polymer sodium hyaluronate gel in total hip arthroplasty can improve postoperative joint mobility and prevent postoperative scar adhesion formation, and improve postoperative pain level.The mechanism may be related to down regulation of IL-4 and TGF- β It's related to the level.