| 吴毅华,罗高斌,黄煜朗,陈 胜,汪 慧,梁 仁.关节镜下清理术联合腓骨截骨术治疗膝关节骨性关节炎的疗效及对炎性因子的影响[J].,2019,19(10):1966-1969 |
| 关节镜下清理术联合腓骨截骨术治疗膝关节骨性关节炎的疗效及对炎性因子的影响 |
| Effect of Arthroscopic Debridement Combined with Fibular Osteotomy on Knee Osteoarthritis and Its Influence on Inflammatory Factors |
| 投稿时间：2019-01-08 修订日期：2019-01-30 |
| DOI：10.13241/j.cnki.pmb.2019.10.035 |
| 中文关键词: 关节镜下清理术 腓骨截骨术 膝关节骨性关节炎 疗效 炎性因子 |
| 英文关键词: Arthroscopic debridement Fibular osteotomy Knee osteoarthritis Efficacy Inflammatory factors |
| 基金项目:广西壮族自治区卫生和计划生育委员会自筹经费科研课题（Z20171008） |
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| 中文摘要: |
| 摘要 目的：探讨采用关节镜下清理术联合腓骨截骨术治疗膝关节骨性关节炎（KOA）的疗效及对炎性因子的影响。方法：选取2015年3月~2017年12月期间右江民族医学院附属河池医院收治的KOA患者99例，根据手术方式的不同将患者分为A组（n=46，关节镜下清理术治疗）和B组（n=53，关节镜下清理术联合腓骨截骨术治疗），比较两组患者手术时间、术中出血量、住院时间，比较两组术前、术后6个月、术后1年疼痛情况、膝关节功能恢复情况、膝关节相关角，比较两组术前、术后1个月炎性因子变化，记录两组术后并发症发生情况。结果：B组手术时间长于A组（P<0.05），两组术中出血量、住院时间比较无差异（P>0.05）。B组术后6个月、术后1年视觉疼痛模拟（VAS）评分低于A组，美国特种外科医院（HSS）、膝关节评分及美国膝关节协会（KSS）评分则高于A组（P<0.05）。两组患者术后1个月白介素-6（IL-6）、肿瘤坏死因子-?琢（TNF-?琢）均较术前降低，且B组低于A组（P<0.05）。B组术后6个月、术后1年膝关节相关角[股骨干与股骨双髁连线夹角（F角）、股骨胫骨角（FT角）、胫股关节间隙角（JS角）]均低于术前以及A组同时间点（P<0.05）。两组术后并发症发生率比较差异无统计学意义（P>0.05）。结论：KOA患者经关节镜下清理术、腓骨截骨术联合治疗后，疗效显著，可有效改善患者疼痛及膝关节功能，降低炎性因子水平，手术方案安全且可改善患者下肢力线。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the efficacy of arthroscopic debridement combined with fibular osteotomy in the treatment of knee osteoarthritis (KOA) and its effect on inflammatory factors. Methods: 99 patients with KOA who were admitted to Hechi Hospital Affiliated to Youjiang Medical University for Nationalities from March 2015 to December 2017 were selected, and they were divided into group A (n=46, arthroscopic debridement) and group B (n=53, arthroscopic debridement combined with fibular osteotomy) according to different surgical methods. The operation time, intraoperative bleeding volume and hospitalization time were compared between the two groups. The pain, knee function recovery and knee joint angle were compared between the two groups before operation, 6 months after operation and 1 year after operation. The changes of inflammatory factors before operation and 1 month after operation were compared between the two groups. The incidence of postoperative complications was recorded in the two groups. Results: The operation time of group B was longer than that of group A (P<0.05). There was no significant difference in intraoperative bleeding volume and hospitalization time between the two groups (P>0.05). Visual analogue pain (VAS) score in group B was lower than that in group A at 6 months after operation and 1 year after operation, while Hospital special surgery (HSS), knee joint score and American knee society score (KSS) score were higher than those in group A (P<0.05). The levels of interleukin-6 (IL-6) and tumor necrosis factor-?琢 (TNF-?琢) were lower in the two groups at 1 month after operation than those before operation, and those in the group B were lower than those in the group A (P<0.05). The knee joint angle (F angle), femoral tibial angle (FT angle), tibiofemoral joint gap angle (JS angle) of group B were lower than those of before operation and group A at simultaneous time point (P<0.05). There was no significant difference in the incidence of complications between the two groups (P>0.05). Conclusion: Arthroscopic debridement combined with fibular osteotomy in the treatment of KOA has a definite effect. It can effectively relieve pain, improve knee function, reduce the levels of inflammatory factors, the surgical procedure is safe and can improve the lower limb force line of patients. |
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