关节镜清理术联合透明质酸钠治疗膝骨性关节炎对关节液炎性因子水平及膝功能的影响

摘要

Objective To analyze the effect of arthroscopic selective debridement combined with sodium hyaluronate on inflammatory factors in synovial fluid and joint function in patients with knee osteoarthritis.Methods Totally 100 patients with knee osteoarthritis from December 2012 to December 2015 in Qinghai Provincial People's Hospital were randomly divided into arthroscopic selective debridement combined with sodium hyaluronate group(group A) and arthroscopic selective debridement group(group B),with 50 cases in each group.Operation time,intraoperative blood loss,joint healing time,weight-bearing exercise time,complications,contents of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in synovial fluid and joint function recovery after treatment were analyzed.Results Operation time in group A was significantly longer,joint healing time and weight-bearing exercise time were significantly shorter than those in group B [(54 ± 6) min vs (50 ± 6) min,(10.6 ±2.0) weeks vs (14.0 ±2.6)weeks,(12.0 ±2.2) weeks vs (16.0 ±2.6)weeks] (P ＜0.05).Intraoperative blood loss showed no significant difference between groups (P ＞ 0.05).No complication was observed in both groups.After treatment,levels of IL-6 and TNF-α in synovial fluid were significantly lower than those before treatment;levels of IL-6 and TNF-α in group A were significantly lower than those in group B [(99 ± 10)ng/L vs (125 ± 25) ng/L,(74 ± 10) ng/L vs (99 ± 11) ng/L] (P ＜ 0.05).Effective rate of joint function recovery in group A was significantly higher than that in group B [90.0％ (45/50) vs 70.0％ (35/50)] (P ＜ 0.05).Conclusion Arthroscopic selective debridement combined with sodium hyaluronate treating knee osteoarthritis can effectively reduce inflammation,improve knee joint function and promote healing and early functional exercise.%目的 探讨关节镜选择性清理术联合透明质酸钠治疗对膝骨性关节炎患者关节液炎性因子水平及关节功能的影响.方法 选取2012年12月至2015年12月青海省人民医院确诊的膝骨性关节炎患者100例,完全随机分为镜钠组和单镜组,每组50例.单镜组给予关节镜选择性清理术治疗,镜钠组在此基础上给予透明质酸钠治疗.比较2组手术时间、术中出血量、关节愈合时间、完全负重功能锻炼时间、并发症发生情况及治疗前后关节液炎性因子[白细胞介素6(IL-6)、肿瘤坏死因子α(TNF-α)]和治疗后关节功能.结果 镜钠组手术时间长于,关节愈合时间、完全负重功能锻炼时间短于单镜组[(54±6) min比(50±6)min、(10.6±2.0)周比(14.0±2.6)周、(12.0±2.2)周比(16.0±2.6)周],差异均有统计学意义(均P＜0.05);2组术中出血量基本相同,差异无统计学意义(P＞0.05).2组均无并发症发生.治疗后,2组关节液IL-6、TNF-α水平明显低于治疗前,且镜钠组低于单镜组[(99±10) ng/L比(125±25) ng/L、(74±10) ng/L比(99±11) ng/L],差异均有统计学意义(均P＜0.05).镜钠组关节功能优良率明显高于单镜组[90.0％ (45/50)比70.0％ (35/50)],差异有统计学意义(P＜0.05).结论 关节镜选择性清理术联合透明质酸钠治疗可有效改善膝骨性关节炎患者炎症状态及关节功能,有利于促进关节愈合及尽早功能锻炼,且具有良好的安全性.