摘要
目的探讨老年膝关节骨性关节炎(KOA)关节镜下不同清理程度的临床疗效及关节功能恢复情况。方法选取2012年1月—2014年12月上海市光华中西医结合医院78例(94膝)老年KOA患者,随机数字表法分为2组,分别采用关节镜下有限清理术(有限组,39例46膝)和关节镜下广泛清理术(广泛组,39例48膝)。比较2组的临床疗效、手术时间、术后恢复时间、术前后VAS评分及Lysholm功能评分变化情况。结果有限组、广泛组的总有效率分别为93.5%(43/46)、95.8%(46/48),差异无统计学意义(x^2=0.26,P>0.05);与广泛组比较,有限组手术时间、术后恢复时间明显缩短(t=6.51、10.52,P<0.05);与术前比较,2组术后1周、6个月,VAS评分均有明显降低(P<0.05),且有限组术后1周的VAS评分显著低于广泛组(P<0.05);术后1、6个月随访,2组Lysholm功能评分均显著改善(P<0.05),术后1个月有限组中Ⅰ级、Ⅱ级患者Lysholm功能评分显著优于广泛组(P<0.05),而术后6个月无统计学意义(P>0.05)。结论关节镜下有限和广泛清理术治疗老年KOA近远期疗效相当,但前者对于病情相对较轻的Ⅰ级、Ⅱ级患者效果更理想,可促进关节功能的恢复。
Objective To investigate the clinical effect of arthroscopic debridement of knee osteoarthritis（KOA） and the recoveiy of the joint function of patients with knee osteoarthritis.Methods Selected from January 2012 to December2014.78 elderly patients（94 knees） with KOA in Shanghai Guanghua Integrative Medicine Hospital,.According to random number table method,they were divide d into 2 groups,respectively,using arthroscopic limited debridement surgery（limited group.39 cases of 46 knees） and arthroscopic extensive cleanup operation（extensive group,39 cases of 48 knees）.The clinical curative effect,operation time,postoperative recovery time,postoperative VAS score and Lysholm functional score were compared between the 2 groups.Results Limited group and extensive group＇s total efficiency were 93.5%（43/46）,95.8%（46/48）.the difference was not statistically significant（x^2 =0.26,P〉0.05）;compared with the extensive group,limited group＇s operative time,postoperative recovery time was significantly shorter（t =6.51,t = 10.52,P〈0.05）;compared with the preoperative.2 group after one week,six months＇ VAS scores were significantly decreased（P〈0.05）,and limited group after one week＇s VAS scores was significantly lower than extensive group（P〈0.05）;after 1,6 months of follow-up,the two groups＇ Lysholm score were significantly improved（P〈0.05）,alter one mouth,limited group＇s grade I,grade Ⅱ patients＇ Lysholm score significantly belter than extensive group（P〈0.05）,and after six months,it was not statistically significant（P〉0.05）.Conclusion Under the arthroscopy,limited and extensive cleaning treatment of elderly patients with KOA were showed the similar effect,but the former is relatively mild,the ellect is more ideal,it can promote the recoveiy of joint function.
出处
《疑难病杂志》
CAS
2016年第3期292-294,302,共4页
Chinese Journal of Difficult and Complicated Cases
基金
上海市长宁区科学技术委员会资助项目(CNKW2014J05)
关键词
膝骨性关节炎
关节镜
广泛清理术
有限清理术
关节功能
Knee osteoarthritis
Arthroscopy
Extensive debridement
Limited clean-up
Joint function
