不同关节腔穿刺方法注射透明质酸钠治疗膝骨关节炎疗效观察

【目的】探讨几种膝关节穿刺方法注射透明质酸钠对膝骨关节炎治疗效果的异同及应用特点。【方法】对79例膝骨关节炎患者共110膝[HSS(hospitl for special surgery)膝关节评分均为良70～84],分采用髌股关节外侧间隙(19例)、内侧间隙(20例)、膝眼穿刺(19例)、髌骨上缘(21例)4种入路穿刺方法,进行膝关节腔透明质酸钠注射治疗,于治疗前及治疗后1个月进行HSS膝关节评分。【结果】各种膝关节穿刺注射方法均一次穿刺注射成功,无并发症,各种穿刺方法组治疗后1个月HSS评分均有明显提高(P<0.05)。【结论】透明质酸钠关节腔注射对轻、中度膝骨关节炎具有积极疗效,髌股关节内、外侧间隙、膝眼及髌骨上缘穿刺注射方法各有特点,均能实现透明质酸钠向膝关节腔的有效注射。

Study on the effects of sodium hyaluronate intra-anticular injection on the treatment of knee osteoarthritis by different arthrocentesis

[Objective] To observe the therapeutic effects of sodium hyaluronate （SH） intra-anticular injection by different arthrocentesis on the treatment of knee osteoarthritis, and to investigate application characters of different arthrocentesis. [Methods] 79 knee osteoarthritis patients[110 knees, HSS （hospitl for special surgery）70 - 84 scores] were treated with intra-articular injection of sodium hyaluronate （SH） through four puncture approaches （lateral patellofemoral joint, 19 patients; medial patellofemoral joint, 20 patients; hsiuen,19 patients; superior margin of patella, 21 patients）. Their clinical symptoms were scored with HSS before and 1 months after injection of sodium hyaluronate. [ Results] SH were all successfully injected through four puncture approaches. The HSS scores were significantly higher at 1 months after injection of sodium hyaluronate than the scores before injection（P 〈 0.05） in every group of different puncture approaches. [Conclusion] Application of intra-articular injection of sodium hyaluronate for mild to moderate knee osteoarthritis has good efficacy, and four puncture approaches （lateral patellofemoral joint, medial patellofemoral joint, hsiuen, superior margin of patella） are all effective injection methods and have different characters.