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關(guān)節(jié)鏡微創(chuàng)技術(shù)治療中老年輕、中度膝關(guān)節(jié)骨性關(guān)節(jié)炎的效果及對(duì)其生活質(zhì)量的影響

發(fā)布時(shí)間:2018-06-23 來源: 散文精選 點(diǎn)擊:


  【摘要】 目的:探究關(guān)節(jié)鏡微創(chuàng)技術(shù)治療中老年輕、中度膝關(guān)節(jié)骨性關(guān)節(jié)炎的效果及對(duì)其生活質(zhì)量的影響。方法:選擇本院2016年4月1日-2018年1月1日收治的膝關(guān)節(jié)骨性關(guān)節(jié)炎患者70例,使用隨機(jī)數(shù)字表法將所有患者分為對(duì)照組(30例)與觀察組(40例)。對(duì)照組患者采用常規(guī)內(nèi)科治療,觀察組在此基礎(chǔ)上進(jìn)行關(guān)節(jié)鏡微創(chuàng)術(shù)治療。分別測定兩組患者血清超氧化物歧化酶(SOD)、超敏C反應(yīng)蛋白(hs-CRP)、一氧化氮(NO)、腫瘤壞死因子α(TNF-α)水平,并對(duì)患者關(guān)節(jié)的疼痛腫脹、功能狀況以及屈伸度進(jìn)行評(píng)估,判定患者療效。結(jié)果:觀察組患者血清SOD水平顯著高于對(duì)照組,hs-CRP、NO、TNF-α水平顯著低于對(duì)照組(P<0.05)。觀察組關(guān)節(jié)靜息痛、壓痛、腫脹指數(shù)顯著低于對(duì)照組(P<0.05)。同時(shí)觀察組關(guān)節(jié)功能評(píng)分及主動(dòng)屈伸度顯著高于對(duì)照組(P<0.05)。結(jié)論:關(guān)節(jié)鏡微創(chuàng)術(shù)治療膝關(guān)節(jié)骨性關(guān)節(jié)炎療效顯著,降低關(guān)節(jié)炎癥水平,改善關(guān)節(jié)功能,值得臨床推廣。
  【關(guān)鍵詞】 關(guān)節(jié)鏡微創(chuàng)技術(shù); 膝關(guān)節(jié); 骨性關(guān)節(jié)炎
  The Effect of Minimally Invasive Arthroscopy in the Treatment of Mild and Moderate Knee Osteoarthritis in the Middle and Old Age and Its Effect on the Quality of Life/YE Heng,SU Peiqun,CHEN Youxuan.//Medical Innovation of China,2018,15(07):013-016
  【Abstract】 Objective:To explore the effect of minimally invasive arthroscopy in the treatment of mild and moderate knee osteoarthritis in the middle and old age and its effect on the quality of life.Method:70 patients with knee osteoarthritis were treated in our hospital from April 1,2016 to January 1,2018,according the random number table method,they were divided into control group(30 case) and observation group(40 case).The control group was treated with routine medical treatment,on the basis of the observation group was given minimally invasive arthroscopic treatment.The serum superoxide dismutase(SOD),high sensitive C reactive protein (hs-CRP),nitric oxide (NO),tumor necrosis factor α (TNF-α) level,patients with joint pain and swelling,flexion and extension function evaluation,the curative effect of two groups were compared.Result:The level of serum SOD in observation group was significantly higher than that of the control group,hs-CRP, NO, TNF-αlevels were significantly lower than those of the control group(P<0.05).The observation group of joint rest pain,tenderness,swelling index were significantly lower than those of the control group(P<0.05).At the same time,the joint function score and active flexion in observation group were significantly higher than those of the control group(P<0.05).Conclusion:Arthroscopic minimally invasive surgery has significant therapeutic effect on osteoarthritis of the knee joint,reduces inflammation,improves joint function,it is worthy of promotion.
  【Key words】 Arthroscopy minimally invasive technique; Knee joint; Osteoarthritis
  First-author’s address:The People’s Hospital of Chaozhou,Chaozhou 521000,China
  doi:10.3969/j.issn.1674-4985.2018.07.004
  膝關(guān)節(jié)骨性關(guān)節(jié)炎(knee osteoarthritis,KOA)是一種多因素引起的疾病,多發(fā)于中年老人群,因此又被稱為老年性關(guān)節(jié)炎[1]。臨床研究顯示,高齡、肥胖、創(chuàng)傷及關(guān)節(jié)先天性疾病等因素均可導(dǎo)致OA發(fā)生,OA患者存在關(guān)節(jié)軟骨退化、關(guān)節(jié)及軟骨反應(yīng)性增生,主要臨床表現(xiàn)為關(guān)節(jié)疼痛、僵硬及功能障礙等[2-3]。其癥狀多在清晨起床時(shí)出現(xiàn),在大量體力勞動(dòng)后可明顯加重,因此患者多因出現(xiàn)關(guān)節(jié)嚴(yán)重疼痛而就診。體格檢查可發(fā)現(xiàn)病變關(guān)節(jié)明顯腫脹、壓痛,活動(dòng)屈伸時(shí)存在明顯摩擦感或出現(xiàn)咔嗒聲等現(xiàn)象,嚴(yán)重情況可有關(guān)節(jié)畸形、肌肉萎縮等嚴(yán)重癥狀,X線檢查可觀察到關(guān)節(jié)四周骨贅明顯增生變形、間隙狹窄等表現(xiàn)[4]。由于OA患者可出現(xiàn)嚴(yán)重的疼痛感及關(guān)節(jié)活動(dòng)度受限,因此其生活質(zhì)量明顯降低。目前治療骨關(guān)節(jié)炎的治療方法較多,其目的主要是用于緩解關(guān)節(jié)疼痛、提高患者的關(guān)節(jié)活動(dòng)度,同時(shí)使患者受損軟骨及正常骨結(jié)構(gòu)得到重建恢復(fù),進(jìn)而緩解病情[4]。隨著關(guān)節(jié)鏡技術(shù)的普及,目前關(guān)節(jié)鏡微創(chuàng)術(shù)在治療膝骨關(guān)節(jié)炎方面具有很大優(yōu)勢。本文通過對(duì)觀察組采用關(guān)節(jié)鏡微創(chuàng)術(shù),評(píng)估其臨床效果,現(xiàn)報(bào)道如下。

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