关节镜下滑膜清理术联合药物注射治疗类风湿性关节炎临床观察.docVIP

关节镜下滑膜清理术联合药物注射治疗类风湿性关节炎临床观察[摘要] 目的 探讨关节镜下滑膜清理术联合关节内注射透明质酸钠治疗类风湿性关节炎的临床疗效。方法 60例类风湿关节炎患者行膝关节滑膜清理术，关节内注射透明质酸钠。术后1个月和术后半年进行随访。术前及各随访时间点，评价患者的VAS评分、Lysholm膝关节评分、血沉（ESR）、C反应蛋白（CRP）和类风湿因子（RF）。结果 患者术后Lysholm评分高于术前（P＜0.05）。术后患者VAS评分和血液学指标均有降低（P＜0.01）。结论 关节镜下滑膜清理术联合注射透明质酸钠治疗类风湿性关节炎能够获得良好的效果。 [关键词] 类风湿性关节炎；关节镜；透明质酸钠；随访 [中图分类号] R593.21[文献标识码] B [文章编号] 1673-9701（2011） 21-27-02 The Effect of Combination of Arthroscopic Synovectomy and Intra-articular Injection in Treating Rheumatoid Arthritis ZHANG Gang1SUN Yingling2 1.Orthopaedics Department II ,Haining City People’s Hospital in Zhejiang Province, Haining 314400，China；2.Department of General Surgery，Haining City TCM Hospital in Zhejiang Province, Haining 314400，China [Abstract] Objective To investigate the effect of combination of arthroscopic synovectomy and intraarticular injection in treating rheumatoid arthritis. Methods Sixty patients with low back pain and legs pain were received arthroscopic synovectomy combined with sodium hyaluronate intraarticular injection. The VAS scores, Lysholm scores, ESR, CRP and RF of each patients were analyzed. Results After a half years? follow-up, the postoperative Lysholm scores were higher than preoperative Lysholm scores（P＜0.05）. Compared with the preoperative score, VAS scores, ESR, RF and CRP were significantly decreased （P＜0.01）. Conclusion Arthroscopic synovectomy combined with intra-articular injection were effective in treating patients with rheumatoid arthritis. [Key words]Rheumatoid arthritis; Arthroscopes ; Sodium hyaluronate ; Follow-up 类风湿性关节炎（rheumatoid arthritis）是一种以关节滑膜炎为特征的慢性全身性自身免疫性疾病。滑膜炎持久反复发作，可导致关节内软骨和骨的破坏，关节功能障碍，甚至残废。血管炎病变累及全身各个器官，大关节中常累及膝关节导致肿胀疼痛和功能障碍等问题。该疾病病因尚未完全清楚，目前也无对因治疗的确切有效方案。临床主要应用改善病情药(disease-modifying anti-rheumatic drugs, DMARDs)的抗风湿药物作为早期治疗。严重者可进行关节镜下清理。关节置换常为终末期治疗。笔者对部分RA患者采用膝关节镜下滑膜清理术联合透明质酸钠注射，现将临床观察报道如下。 1#8195;资料与方法 1.1#8195;一般资料 选择2008年2月～2009年8月在我院就诊的老年腰腿痛患者60例，男40例，女20例，年龄30～68岁，平均40.5岁，其中20例为双膝关节受累，共80个膝关节。诊断标准参照美国