【摘要】 目的分析分度流程化保守治疗对中重度膝骨性关节炎(KOA)关节功能的影响,并与关节镜治疗效果进行比较。方法选择2010年3月—2013年6月收治的符合标准的中重度KOA患者共44例(53膝),采用随机数字表法分为分度流程化治疗组23例(28膝)和关节镜组21例(25膝)。术后对患者进行随访,对比分析两组治疗前后Lysholm膝关节功能评分、复发率,检测关节液中白介素(IL)-6和肿瘤坏死因子(TNF)-α水平改变。结果分度流程化治疗组和关节镜组治疗后1、3、6、12个月时Lysholm膝关节功能评分均高于治疗前,差异有统计学意义(P<0.01);但两组治疗后不同时间点Lysholm膝关节功能评分比较,差异均无统计学意义(P>0.05)。两组患者治疗前及治疗后1个月时关节液IL-6和TNF-α水平间差异均无统计学意义(P>0.05);治疗后1个月,两组IL-6和TNF-α水平均较治疗前降低,差异有统计学意义(P<0.05)。两组患者治疗后3、6、12个月时膝关节疼痛复发率比较,差异均无统计学意义(P>0.05)。结论分度流程化保守治疗与关节镜治疗中重度KOA的效果相当,均能有效缓解KOA的临床症状,且较关节镜治疗简单易行,易被患者接受。更多还原

【Abstract】 Objective To investigate the effect of graded and processized conservative treatment on the joint function of patients with moderate and severe knee osteoarthritis and compare its efficacy with arthroscopic treatment. Methods We enrolled 44 patients( 53 knees) with moderate and severe knee osteoarthritis who accorded with the inclusion criteria and were admitted into the Second Hospital of Xiangtan from March 2010 to June 2013. Using random number table method,23 patients( 28 knees) were assigned into graded and processized conservative treatment group and 21 patients( 25 knees) were assigned into arthroscopic group. Follow-up visits were conducted on the patients,comparison was made between the two groups in Lysholm score and recurrence rate,and the levels of IL-6 and TNF-α in synovial fluid were examined. Results The two groups had higher Lysholm score 1,3,6 and 12 months after treatment than that before treatment( P < 0. 01); the two groups were not significantly different in Lysholm score at different time points( P > 0. 05) after treatment. The two groups were not significantly different in the levels of IL-6 and TNF-α in synovial fluid before treatment and 1 month after treatment( P > 0. 05); the levels of IL-6 and TNF-α in synovial fluid 1 month after treatment of the two groups were significantly different from those before treatment( P < 0. 05). The two groups were not significantly different in the recurrence rate of knee joint ache 3,6 and 12 months after treatment( P > 0. 05). Conclusion Graded and processized conservative treatment and arthroscopic treatment have similar efficacy and both can alleviate clinical symptoms of knee osteoarthritis. Graded and processized conservative treatment is simpler and easier in practice than arthroscopic treatment,thus it is more acceptable by patients.更多还原