摘要
目的观察肌骨超声技术在检查膝骨关节炎时图像表现,并分析肌骨超声技术在提高和评价针刀治疗膝骨关节炎疗效中应用价值。方法选择深圳市大鹏新区南澳人民医院2016年6月至2018年6月入院治疗98例患者,其中男性51例,女性47例;年龄42~74岁,平均年龄57.67岁;体质量指数为18.7~24.7 kg/m^2,平均体质量指数为22.69 kg/m^2。治疗前后行超声检查和针刀治疗。观察并比较治疗前后患者超声图像表现,治疗前后疼痛情况、功能障碍情况及生活质量。结果治疗前,超声图像显示患者滑膜增生肥厚,关节腔内大量积液,关节软骨毛糙、变薄,腘窝表现囊肿,肌肉组织中肌纤维排列紊乱,肌腱端增生肥厚,骨面毛糙且连续性中断;治疗后,超声图像显示患者滑膜已变薄,关节腔中积液也被明显吸收,腘窝囊肿趋于消失,关节软骨已由毛糙变得光滑,肌纤维排列也变得清晰,骨面也由毛糙变得平滑且连续性良好。治疗后,患者滑膜厚度[(2.21±0.41)mm]、关节腔积液范围[(6.56±0.75)cm^2]及关节软骨厚度[(2.05±0.35)mm]分别低于治疗前[(6.15±1.03)mm、(25.04±2.69)cm^2、(6.01±0.98)mm],治疗前后差异有统计学意义(P<0.05)。治疗后,患者疼痛视觉模拟量表(VAS)评分[(3.11±1.01)分]、功能障碍指数[(21.35±5.05)分]分别低于治疗前的(6.13±1.45)分、(36.01±4.98)分,差异有统计学意义(P<0.05);治疗后,患者的生活质量各条目评分[(25.21±3.41)分、(26.56±3.04)分、(26.35±3.05)分、(25.45±3.21)分、(25.33±3.15)分、(25.97±3.11)分]分别高于治疗前[(19.35±4.22)分、(19.94±4.69)分、(20.01±4.28)分、(20.42±3.92)分、(19.87±4.02)分、(19.84±4.21)分],差异具有统计学意义(P<0.05)。结论在对膝骨关节炎患者实施针刀治疗前,采用肌骨超声技术对其进行全面检查,可以清楚地显示患者膝骨关节病变情况,为膝骨关节炎患者的针刀治疗提供了有效的参考依据,利于患者疼痛、功能障碍等临床症状的改善,以及生活质量的提高,并且在治疗后再次采用肌骨超声技术对患者实施检查,可以有效评价针刀治疗的临床效果。
Objective To observe image manifestation of musculoskeletal ultrasound in examination of knee osteoarthritis,and analyze application value of musculoskeletal ultrasound in improving and evaluating curative effects of needle knife in treat-ment of knee osteoarthritis.Methods From June 2016 to June 2018,a total of 98 patients were enrolled,which included 51 males and 47 females,aged 42-74 years old with mean age of 57.67 years old;body mass index(BMI)was 18.7-24.7 kg/m^2 with mean BMI of 22.69 kg/m^2.The ultrasonography and needle-knife were performed.The ultrasonographic manifestations,pain degree,dysfunction conditions and quality of life before and after treatment were compared.Results Before treatment,ultrasound images showed hypertrophy of synovium,massive fluid accumulation in intra-articular cavity,rough and thin articu-lar cartilage,cysts in popliteal fossa,disordered arrangement of muscle fibers,hypertrophy of tendon tip,rough and continuous interruption of bone surface.After treatment,ultrasound images showed synovium thinned,effusion in articular cavity obviously absorbed,popliteal cyst tended to disappear,articular cartilage was smooth,arrangement of muscle fibers became clear,and bone surface changed smooth with well continuity.After treatment,synovial membrane thickness[(2.21±0.41)mm],range of articular effusion[(6.56±0.75)cm^2]and thickness of articular cartilage[(2.05±0.35)mm]were significantly lower than those of before treatment[(6.15±1.03)mm,(25.04±2.69)cm^2 and(6.01±0.98)mm](P<0.05).The pain score visual analogue scale(VAS)[(3.11±1.01)scores]and dysfunction score[(21.35±5.05)scores]were significantly lower than those of before treatment[(6.13±1.45)scores,(36.01±4.98)scores](P<0.05).The scores of each quality of life item[(25.21±3.41)scores,(26.56±3.04)scores,(26.35±3.05)scores,(25.45±3.21)scores,(25.33±3.15)scores and(25.97±3.11)scores]were significantly higher than those of before treatment[(19.35±4.22)scores,(19.94±4.69)scores,(20.01±4.28)scores,(20.42±3.92)scores,(19.87±4.02)scores,(19.84±4.21)scores](P<0.05).Conclusion It is demonstrated that the comprehensive examination before operation of knee osteoarthritis by musculoskeletal ultrasound could clearly show pathology of knee joint disease,which provide effective reference for treatment and improve clinical symptoms of pain and dysfunction,and improve quality of life.After treatment,the musculoskeletal ultrasound could effectively evaluate clinical effect of needle knife treatment.
作者
潘巍一
葛俊胜
张捷洪
柯秀君
王玉龙
PAN Wei-yi;GE Jun-sheng;ZHANG Jie-hong;KE Xiu-jun;WANG Yu-long(Department of Rehabilitation,Nanao People’s Hospital,Dapeng New District,Shenzhen 518121,Guangdong,China;Rehabilitation Center,First Affiliated Hospital of Shenzhen University,Shenzhen 518000,Guangdong,China)
出处
《生物医学工程与临床》
CAS
2020年第1期50-54,共5页
Biomedical Engineering and Clinical Medicine
关键词
肌骨超声技术
膝骨关节炎
针刀治疗
图像表现
临床效果
myoskeletal ultrasound
knee osteoarthritis
needle-knife therapy
image manifestations
clinical effect
