临床分度流程化保守治疗膝骨性关节炎的临床研究

摘要

Objectjve To investigate the therapeutic efficacy of procedural conservative treatment for knee osteoarthritis(KOA)based on clinical grading. Methods A total of 132 patients(166 knee joints)with KOA who were admitted to the Second Hospital of Xiangtan during March 2010 to June 2013,were divided into two groups by random table method:control group(62 cases,76 knee joints)and procedural conservative treatment group(PT group,including 70 cases, 90 knee joints). Patients in control group were treated with intra - articular injection of sodium hyaluronate,and took NSAIDs orally;patients in PT group received procedural conservative treatment based on clinical grading. Lysholm knee function scores and NSAIDs scores before and after treatment were compared between two groups. Results According to results of comparison of Lysholm knee function scores and NSAIDs before and after treatment between two groups,the interactive effect existed between treatment method and treatment time(P < 0. 05);there was significant difference between the 2 groups;there was significant difference among different time points( P < 0. 05). 2 days,14 days,1 month,3 months and 6 months after treatment, Lysholm knee function scores of knees in PT group were significantly higher than those of knees in control group(P < 0. 05);2 days,14 days,1 month,3 months and 6 months after treatment,Lysholm knee function scores of knees in PT group and control group were significantly higher than those before treatment(P < 0. 05). 6 months after treatment,NSAIDs scores of knees in PT group were significantly lower than those of knees in control group(P < 0. 05);3 months and 6 months after treatment,NSAIDs scores of knees in PT group and control group were significantly lower than those before treatment(P < 0. 05). Conclusjon Targeted treatment for KOA based on clinical grading can achieve good therapeutic efficacy and prognosis.%目的：探讨膝骨性关节炎（KOA）的临床分度流程化保守治疗（PT）的效果。方法选取2010年3月—2013年6月在湘潭市二医院住院的 KOA 患者132例（166膝），采用随机数字表法分为2组：对照组62例（76膝），PT 组70例（90膝）。对照组患者给予膝关节内注射透明质酸钠治疗，适当给予非甾体抗感染药（NSAIDs）口服；PT 组根据临床分度调整治疗。分别比较两组患膝治疗前后的 Lysholm 膝关节功能评分和 NSAIDs 评分。结果两组患膝治疗前后 Lysholm 膝关节功能评分和 NSAIDs 评分，治疗方法与治疗时间有交互作用（P <0.05）；组间比较，差异有统计学意义（P <0.05）；时间间比较，差异有统计学意义（P <0.05）。治疗后第2天、第14天、1个月、3个月、6个月 PT 组患膝 Lysholm 膝关节功能评分高于对照组（P <0.05）；对照组和 PT 组患膝治疗后第2天、第14天、1个月、3个月、6个月 Lysholm 膝关节功能评分高于治疗前（P <0.05）。治疗后6个月 PT 组患膝 NSAIDs 评分低于对照组（P <0.05）；对照组和 PT 组患膝治疗后3个月、6个月 NSAIDs 评分低于治疗前（P <0.05）。结论对 KOA 患者进行临床分度并采取针对性治疗的方案对 KOA 患者的疗效、预后有积极意义。