张泽

[摘要]目的 探讨膝关节镜治疗症状性膝关节骨关节炎的临床效果。方法 选取2016年1月～2017年7月我院收治的80例症状性膝骨性骨性关节炎患者作为研究对象，按照随机数字法分为两组（对照组与观察组），每组各40例。对照组患者实施玻璃酸钠注射液膝关节腔内注射，观察组患者在对照组基础上，实施膝关节镜下关节清理术，比较治疗过程中患者的膝关节疼痛VAS评分，治疗后患者膝关节ROM角度变化和膝关节Lysholm功能评分，统计两组患者的临床效果。结果 治疗后1周和治疗后4周，观察组患者的膝关节疼痛VAS评分低于对照组（P<0.05）；治疗后观察组患者的膝关节ROM角度大于对照组（P<0.05），膝关节Lysholm功能得分高于对照组（P<0.05）；观察组患者的治疗优良率为95.0%，显著高于对照组的75.0%，差异均有统计学意义（P<0.05）。结论 针对存在明显临床症状的膝关节骨性关节炎患者，以膝关节镜联合玻璃酸钠治疗，可有效缓解患者疼痛，改善膝关节功能，提高临床治疗效果。

[关键词]膝关节镜；膝关节骨关节炎；疼痛；膝关节功能

[中图分类号] R394.2 [文献标识码] A [文章编号] 1674-4721（2018）2（c）-0050-03

[Abstract]Objective To investigate the clinical efficacy of knee arthroscopy in the treatment of symptomatic knee osteoarthritis.Methods 80 cases with symptomatic knee osteoarthritis treated in our hospital from January 2016 to July 2017 were selected as the subjects，and divided into the two groups （control group and observation group） by random table method，40 cases in each group.The control group were treated with intraperitoneal injection of sodium hyaluronate injection in the knee joint.The observation group was treated with knee arthroplasty under the control group.The VAS score of the knee joint pain during the treatment were compared，the joint ROM angle changes，knee Lysholm functional score and the overall clinical treatment between the two groups were compared.Results The VAS score of knee joint pain in the observation group was lower than the control group at 1 week and 4 weeks after treatment（P<0.05）.The ROM angle in the observation group was higher than that in the control group （P<0.05）.The Lysholm function score in the observation group was higher than that in the control group （P<0.05）.The excellent rate of overall treatment in the observation group was 95.0%，which was significantly higher than 75.0% of the control group，the difference was statistically significant （P<0.05）.Conclusion Knee arthritis combined with sodium hyaluronate can effectively relieve pain in patients with knee joint，improve knee function，and improve the clinical effect in the treatment of osteoarthritis of knee joint with obvious clinical symptoms.

[Key words]Knee arthroscopy；Knee osteoarthritis；Pain；Knee joint function

膝骨性關节炎是临床最为常见的膝退行性关节疾病，好发于中老年人群，尤以绝经后女性患者居多[1]，病理生理改变以关节软骨退行性变化为主要病因[2]。研究显示，年龄为60岁以上的老年女性，本病发生率在50%左右[3]，主要以存在早期的关节影像学改变为主，但多数患者无明显临床症状，改变以分子阶段为主，针对此类患者多未能引起足够的临床重视。目前对于本病的治疗，建议膝关节腔内注射玻璃酸钠，补充外源性的关节液进而延缓关节软骨的退行性变化，稀释关节腔内炎症介质的水平，改善关节软骨的润滑情况，达到改善关节腔内滑液的性质[4]，提高临床治疗效果的目的。但单纯应用玻璃酸钠注射液关节腔内给药，虽可于短期内针对患者关节症状起到一定的改善作用，但治疗时间长、费用高，同时反复膝关节腔有创穿刺[5]，还有可能导致膝关节腔感染，存在一定的医疗风险[6]。目前临床急需一种有效的治疗方法，用于提高膝关节骨性关节炎患者的临床治疗效果，减少并发症。关节镜近年来用于治疗膝关节相关疾病的效果十分显著，具有微创、效果可靠等优点，本研究旨在探讨膝关节镜治疗症状性膝关节骨关节炎的临床效果，现报道如下。