关节镜清理、透明质酸钠注射加中药熏蒸治疗膝关节骨关节炎的临床分析-外科学(骨科)专业论文.docxVIP

硕士学位论文 硕士学位论文 中文摘要 摘 要 目的：探讨关节镜清理、透明质酸钠注射和中药熏蒸关节治疗膝关节 骨关节炎的临床疗效。 方法：214膝膝关节骨关节炎KellgrenLawrence I、II、Ⅲ级患者， 所有病例均经NS触Ds药物和除本组疗法以外的非手术治疗疗效欠佳，均 符合关节镜清理适应症，建议关节镜清理术。所有病例分为三组：A组为 接受手术者术后加行透明质酸钠注射和中药熏蒸；B组为单纯行透明质酸 钠注射者；C组为单纯行透明质酸钠注射和中药熏蒸者(患者根据意愿、 经济等情况自行选择其治疗方法)。X线KellgrenLawrence分级【9】和 Lysholm膝关节功能评分【10】组间均无显著性差异(乃O．05)。年龄和性别 组间无显著性差异(乃O．05)。随访184膝，分成三组，A组61膝，B组 63膝，C组60膝，结果使用SPSSl3．0软件行数据分析。 结果：根据Lysholm膝关节功能评分标准包括跛行、支撑、绞锁、 不稳定、疼痛、肿胀、爬楼梯、下蹲8个项目，根据症状轻重评分，取各项 评分之和，总分满分100分，对治疗前、后进行评分。以治疗后较治疗前计 分值之差为疗效判定依据，差值≥30分为显效(优)，11～29分为有效 (良)，6--10分为进步(差)。随访两年以上，平均36月。A组：10月优良 率97．1％，23月优良率90．5％，30月优良率83．2％。B组：10月优良率 87．4％，23月优良率84．2％，30月优良率76．8％。C组：10月优良率75．8 ％，23月优良率60．1％，30月优良率55．7％。 结论：三种方法治疗膝关节骨关节炎均有疗效，关节镜清理、透明质 酸钠注射和中药熏蒸组疗效最好，关节镜清理和透明质酸钠注射组次之， 透明质酸钠和中药熏蒸组较差。近期疗效较好，远期疗效较差。(PO．05) 关键词： 骨关节炎，关节镜，透明质酸钠，中药 硕士学位论文 硕士学位论文 英文摘要 Abstract Objective：To analyses clinical effection of the arthroscopic debridements，sodium hyaluronate injections and chinese medicine fumigation for the therapy of osteoarthritis of the knee． Methods：214 knees with osteoarthritis of knee were defined KellgrenLawre— nee’s I，II，Ⅲgrade by X·ray．They had used NSAIDs drugs and other conservative treatment．All the treatments were not satisfactory except the next three we used．All were accord with the indication of the arthroscopic debridements and suggested to be treated by arthroscopic debridements．184 knees were got follow—up，were divided into three therapic groups by patients’desire section and at random．A group were 61 knees，were treated by arthroscopic debridements，sodium hyaluronate injections and Chinese medicine fumigation；B group were 63knees，were treated by arthroscopic debridements and sodium hyaluronate injections；C group were 60 knees，were treated by sodium hyaluronate injections and Chinese medicine fumigation．The analysis of data use the statistic software of SPSS 13．0．The differences between groups were not significant p0．05)． Results：Patients were followed up for more than two years，36months at ave