引起膝关节骨性关节炎常见临床症状的病因分析.pdfVIP

2012 年 10 月第 32 卷第 10 期 湖南中医药大学学报 Oct. 2012 Vo l. 32 No. 10 Journal ofTCM Univ. ofHunan 69 引起膝关节骨性关节炎常见临床症状的 病因分析 黄乐天，和晓峰，刘兵 (云南省第二人民医院疼痛科云南昆明 650021 ) 〔摘要〕目的探讨膝关节骨性关节炎 (KOA) 常见症状的起因与发病规律。方法回顾性分析1 012例出院时疗效好 价优的KOA忠者，观察引起常见症状的病灶部位、常见病灶所反应出的临床表现及病灶的分布规律。结果 8 1.54%的交感 神经症状由膝后内侧病灶引起; 73.42%的病士生位于肌骨附着部; 92.13%的疼痛野远离病灶; 92.62%的关节积液与关节外 滑膜邻近组织的炎症有关; 24.21%的KOA存在椎管内的神经f压; A在肌的病灶可以引起伸膝受限，伸肌的病灶可以引起 屈膝受限。结论保障神经和血管的畅通是抑制关节退变的前提;滑膜邻近组织炎症的长期存在是滑膜炎经久不愈的重要 原因:关节软组织的无菌性炎症是引起KOA疼痛的主要原因;椎管内的神经卡压可促使KOA出现症状或使症状加重。 〔关键词〕膝关节骨性关节炎;临床症状;病灶分布;发病规律 〔申图分类号) R684.3 〔文献标识码) B 〔文章编号) doi: 10.3969/j .issn.1674-070X.20 12.10.031.069.02 The pathogenesis of clinical s严nptomsin 函lee Osteoarthritis HUANG Le-tian ,HE Xiao-feng,LIU Bing (Department of pain management ,The Second Hospital of Yunnan Province ,Kunming ,Yunnan 650021 ,China) (Abstract) Objective Study of the etiology and Pathogenesis regularity in Knee Osteoarthritis(KOA). Methods 1012 discharged patients who received definite therapeutic effect on KOA in the hospital were analyzed retrospectively. Observation of the distribution and clinical symptoms of comrnon lesion sites that lead to clinical pain. Results 81.54% of s严npathetic s严nptoms Caused by lesion sites located in posteromedial Knee; 73 .42% of lesion sites located in muscle insertions; 92.l3% ofpainful area far 企om the lesion sites; 92.62% of 也ejoint effusion Caused by the inflammation in Synoviume and a司jacent tissues out of knee joints. 24.2l % of KOA accompanied with intraspinal nerve roo