关节镜手术与非手术疗法治疗膝关节骨关节病临床疗效的对比研究

摘要

目的 评价关节镜手术治疗膝关节骨关节病患者的临床疗效.方法 采用随机平行对照试验设计方案,将100例膝关节骨关节病患者随机分为试验组和对照组,各50例.试验组的患者给予关节镜手术治疗,对照组的患者保守治疗.采用西安大略和麦克马斯特大学骨关节炎指数(WOMAC)、视觉模拟评分法(VAS)、健康调查简表(SF-36)评价2组疗效和不良反应发生情况并进行比较.结果 治疗后,WOMAC评分显示,试验组患者疼痛、功能障碍和僵硬的评分均小于对照组,差异均有统计学意义(P＜0.01);VAS评分显示,试验组患者评分也低于对照组,差异也有统计学意义(P＜0.01);SF-36评分显示,试验组患者活动功能、身体限制、身体疼痛、总体健康、活力、社会功能、情感限制、精神健康、身体健康和心理健康各项评分均显著优于对照组,差异均有统计学意义(P＜0.05);2组患者各不良反应比较差异均无统计学意义(P＞0.05).结论 关节镜手术治疗膝关节骨关节病疗效优于保守疗法,不良反应少且轻.%Objective This study aimed to assess the effectiveness and safety of arthroscopic surgery therapy (AST) for treating knee osteoarthritis (KOA).Methods This study was designed as a randomized parallel control trial,and 100 KOA participants were randomly divided into an intervention group and a control group,50 subjects each group.The participants in an intervention group received AST,while the subjects in a control group received non-surgery therapy.The outcomes include The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC),Visual Analogue Scale/Score (VAS),the MOS item short from health survey (SF-36) and adverse events.Results After treatment,the WOMAC scales in an intervention group were less than those in a control group with pain,dysfunction and stiffness,respectively.Significant differences were found between two groups (P ＜0.01).The VAS score in an intervention group were lower than that in a control group,with significant difference between two groups (P ＜0.01).The SF-36 sub-scales of activity function,physical limitation,pain,total healthy,vitality,social function,emotion limitation,mental health,physical health,and psychological health in an intervention group were superior to those in a control group,with significant differences between two groups (P ＜0.05).However,no significant differences of adverse events were found between both groups (P ＞0.05).Conclusion The effectiveness of arthroscopic surgery therapy is superior to the non-surgery treatment for treating knee osteoarthritis with few adverse events.