正交设计下膝关节外周神经射频消融治疗膝关节骨关节炎

摘要

Objective Explore a new treatment by orthogonal design of no empty cases :treatment of knee osteoarthritis by nerve locator ,for knee joint peripheral nerve branch implement selective radio frequency ablation .Methods According to patients′age ,body mass index ,gender ,organs ,in the course of the disease ,preoperative VAS score ,first divided into nine groups ,each group of four people ,then randomly assigned to four groups and each group 9 cases ,a total of 36 people .With nerve locator ,design of 4 factors and 3 levels ,no empty cases of orthogonal design ,every time 9 people by radio frequency ablation treatment of knee joint pe-ripheral nerve .Repeat 4 times to reduce the sampling error ,obtain the VAS difference between postoperative 1 week and preopera-tive .Results The best combination of treat knee joint osteoarthritis by Radio frequency ablation was A3B3C(1-3)D(1-3) .Selective radio frequency ablation knee peripheral nerve branch target rf temperature is 90 ℃ ,120 seconds ,lidocaine concentration(0 .5% to 2% ) and lidocaine measurement (0 .5 to 1 .5 mL) .Conclusion Using the orthogonal design of no empty cases ,for knee joint pe-ripheral nerve branch for selective radio frequency ablation by nerve locator .Treatment of knee joint osteoarthritis in A3B3C(1-3) D (1-3) combination effect exact ,minimally invasive ,safe ,accurate location ,the treatment effect is good ,low cost ,simple and high ef-ficiency .%目的：无空例正交设计下探索一种新的治疗方法：在神经定位仪下，对膝关节的外周神经支实施选择性射频消融术，治疗膝关节骨关节炎（KOA）。方法根据患者年龄、体质量指数、性别、发病部位、病程、术前VAS评分，将36例患者先分为9组每组4例，再次随机分配到4组每组9例，设计膝关节周围神经在神经定位仪下射频消融术治疗，分为4因素3水平无空例正交设计，每次9例，为减少抽样误差重复4次。取其术后1周与术前VAS差值。结果射频消融治疗膝关节骨性关节炎的最佳组合是A3B3C（1-3）D（1-3），每个神经定位仪下膝关节外周神经支选择性射频消融术的靶点射频温度90℃时间120 s ，利多卡因浓度（0．5％～2％）及利多卡因计量（0．5～1．5 mL ）。结论神经定位仪下对膝关节外周神经支进行选择性射频消融术在A3B3C （1-3）D（1-3）组合下治疗效果定位精确、安全、简便且效率高。