摘要
目的 观察关节镜下清理加去神经化与人工全膝关节置换治疗重度膝骨关节病的临床疗效。方法 选取我院2010年1月-2014年10月收治的重度膝骨关节病患者70例,根据治疗方案的不同分为研究组与对照组各35例。研究组进行关节镜下清理加去神经化治疗,对照组进行人工全膝关节置换治疗。观察两组患者手术前后视觉模糊疼痛评分（VAS）、Lysholm膝关节功能指数评分等,所有患者术后均进行临床随访,并于术后1年进行优良率评价和比较。结果 1两组患者术前VAS比较差异无统计学意义（P〉0.05）;研究组术后3、6、12个月VAS评分分别为（1.71±0.77）、（1.51±0.61）、（2.08±0.69）分,对照组分别为（2.78±0.79）、（2.65±0.82）、（3.01±0.92）分,差异均有统计学意义（均P〈0.05）。2两组患者术前Lysholm膝关节功能指数评分比较差异无统计学意义（P〉0.05）;研究组术后3、6、12个月Lysholm膝关节功能指数评分分别为（83.61±3.59）、（88.89±4.31）、（87.68±3.54）分,对照组分别为（76.06±2.87）、（83.38±4.26）、（78.35±11.18）分,差异均有统计学意义（均P〈0.05）。3术后1年手术优良率,研究组为85.71%,对照组62.86%,差异有统计学意义（P〈0.05）。结论 关节镜下清理加去神经化治疗重度膝骨关节病具有较好的临床效果,术后能够显著减轻患者疼痛,改善膝关节功能。
Objective To investigate the clinical efficacy of arthroscopic debridement combined with denervation and artificial total knee replacement in the treatment of severe knee osteoarthritis. Methods Seventy patients with severe knee osteoarthritis admitted to our hospital from January 2010 to October 2014 were selected and divided into the study group and the control group according to the treatment regimen,with each group 45 cases.The study group was given arthroscopic debridement combined with denervation and the control group was given artificial total knee replacement. The preoperative and postoperative visual analogue scale scores （VAS） and Lysholm knee joint function index scores of the two groups were observed.All the patients received postoperative clinical follow-up and the excellent and good rates 1 year after surgery were evaluated and compared. Results （1）The preoperative VAS was not significantly different in the two groups （P〉0.05）.The VAS scores 3 months,6 months and 12 months after the operation was （1.71±0.77）,（1.51± 0.61） and （2.08±0.69） scores respectively and that of the control group was （2.78±0.79）,（2.65±0.82） and （3.01±0.92） scores respectively,with significant differences （all P〈0.05）.（2）The preoperative Lysholm knee joint function index Score of pa- tients were not significantly different in the two groups （P〉0.05）.The Lysholm knee joint function index scores 3 months, 6 months and 12 months after the operation was （83.61±3.59）,（88.89±4.31） and （87.68±3.54） scores respectively and that of the control group was （76.06±2.87）, （83.38±4.26） and （78.35±11.18） scores respectively,with significant differences （P〈0.05）.（3）The operation excellent and good rate 1 year after surgery was 85.71% in the study group and 62.86% in the control group,with significant difference （P〈0.05）. Conclusion Arthroscopic debridement combined with denervation shows good clinical effects in the treatment of severe knee osteoarthritis as it can significantly relieve the patient＇s pain and improve knee joint function.
出处
《中国当代医药》
2016年第13期74-77,共4页
China Modern Medicine
