酮咯酸氨丁三醇关节腔内注射对膝骨性关节炎患者镇痛作用研究.docxVIP

酮咯酸氨丁三醇关节腔内注射对膝骨性 关节炎患者镇痛作用研究 宋雪 杨大伟 毕春强 张立源 万家兴 中国中医科学院广安门医院南区骨二科 摘要： 口的探讨酮咯酸氨丁三醇关节腔内注射对膝骨性关节炎(KOA)患者的镇痛作 用。方法将2016年5月-2017年5月收治的K0A患者51例，按照随机数字表 法分为对照组25例和治疗组26例。两组患者均常规皮肤消毒，选取穿刺部位， 抽尽关节积液后，对照组单纯给予透明质酸钠(SH)关节腔内注射，2ml/次，1 次/周，连续治疗5次为1个疗程。治疗组在第卩周单纯给予SH关节腔内注射, 第护周加用酮咯酸氨丁三醇，1 ml/次，1次/周，共治疗5周。观察西大略湖和 麦克马斯特(W0MAC)骨关节炎指数评分(包括疼痛、关节僵硬、躯体功能)和 视觉模拟评分(VAS)情况。结果两组患者治疗1个疗程后，对照组总有效率为 88.0%,治疗组为92. 3%,两组比较差异无统计学意义(P0. 05)。两组患者治 疗后W0MAC骨关节炎指数评分情况均明显优于本组治疗前(P0. 05),且治疗组 治疗后疼痛和总评分情况显著优于对照组(P0. 05)。两组患者治疗1、2、3、 4周后VAS评分与本组治疗前比较，差异有统计学意义(P0. 05)。两组患者治 疗1、2周VAS评分均明显低于治疗3、4周(P0. 05),且与对照组同期比较也 均明显降低(P0. 05);两组治疗3、4周后评分相当，与对照组比较差异无统计 学意义(P0. 05)。结论 酮咯酸氨丁三醇关节腔内注射治疗K0A安全有效，可 迅速缓解疼痛，方法简便易行，值得临床推广应用。 关键词： 膝骨性关节炎;关节腔内注射;酮咯酸氨丁二醇;透明质酸钠; 作者简介：宋雪，Ema订:songxue. 0166@163. com 收稿日期：2017-08-15 Analgesic Effects of the Intra-Articular Injection of Ketorolac Tromethamine in the Patients of Knee Osteoarthritis SONG Xue YANG Da-wei BI Chun-qiang ZHANG Li-yuan WAN Jia-xing Second Department of Orthopedics, South Branch of Guanganmen Hosp it al, China Academy of Chinese Medical Sciences; Abstract： Objective To discuss the analgesic effects of the intra-articular injection of ketorolac tromethamine ( KT) in the patients of knee osteoarthritis ( KOA) . Methods From May 2016 through to May2017, 51 cases of KOA were collected and divided into a control group ( 25 cases) and a treatment group ( 26 cases) according to random number table. For the patients in all of the two groups, the local skin was sterilized routincly and the joint effusion was withdrawn before intra-articular injection. In the control group, the sodium hyaluronate ( SH) was used in the injection, 2 ml each time, once a week, continuously for 5 limes as 1 course. In the treatment group, in the first 1 ~ 3 weeks, Sil was used in the intra-articular injection; and in the 4 thto 5 thwccks, KT was added, 1 ml each time, once a week, totally for 5 weeks. WOMAC scores ( including pain, joint stif fn ess and soma tic function) and VAS scores were ob