微创针刀镜治疗膝关节痛风性关节炎的疗效观察

发布时间：2018-10-30 16:00

【摘要】：目的：探讨微创针刀镜治疗膝关节痛风性关节炎的临床疗效。方法：研究对象选取自2014年6月至2015年12月在广州中医药大学第一附属医院风湿科病房住院治疗的60例膝关节痛风性关节炎的患者(均符合诊断标准、纳入标准及排除标准),随机分为两组,治疗组与对照组各30例。其中男性54例,女性6例：年龄26-75岁,平均年龄53.78±12.34岁。对照组口服塞来昔布胶囊、别嘌醇片及碳酸氢钠片治疗,治疗组在口服药物治疗基础上行微创针刀镜治疗,观察时间为1周。选取治疗前、治疗后7天时间点上观察患者VAS评分、膝关节功能Lysholm评分、血尿酸、C反应蛋白、红细胞沉降率,对比两组患者治疗前后各项评分、指标的变化,结果采用自身前后对照及组间对照并进行统计学分析结果(SPSS 19.0统计软件)。成果：根据VAS评分、Lysholm评分、血尿酸、C反应蛋白、红细胞沉降率的结果显示,微创针刀镜联合药物对比单纯药物治疗膝关节痛风性关节炎,两组患者在组内对照、组间对照治疗前后VAS评分、C反应蛋白、红细胞沉降率、Lysholm评分变化差异均有统计学意义(P0.05),组内对照血尿酸在治疗前后具有统计学意义(P0.05),组间对照血尿酸在治疗前后无统计学意义(P0.05)。术后随访结果显示患者复发频率显示治疗组优于对照组。结论：微创针刀镜联合药物和单纯药物治疗膝关节痛风性关节炎均能缓解患者疼痛、肿胀、改善膝关节功能及促进急性炎症指标下降。微创针刀镜能更快缓解疼痛、促进膝关节功能改善,有效减低复发频率,相比单纯药物治疗疗效更佳,是一种具有安全、有效、操作简便、术后功能恢复快等优点的治疗手段,值得进一步推广应用。
[Abstract]:Objective: to investigate the clinical effect of minimally invasive needle-knife and endoscope in the treatment of knee joint gouty arthritis. Methods: from June 2014 to December 2015, 60 patients with gouty arthritis of knee joint were treated in the Department of Rheumatology, the first affiliated Hospital of Guangzhou University of traditional Chinese Medicine (all in accordance with diagnostic criteria, inclusion criteria and exclusion criteria). Randomly divided into two groups, treatment group and control group of 30 cases. There were 54 males and 6 females, aged 26 to 75 years, with an average age of 53.78 卤12.34 years. The control group was treated with celecoxib capsules, allopurinol tablets and sodium bicarbonate tablets. The VAS score, knee function Lysholm score, serum uric acid, C-reactive protein, erythrocyte sedimentation rate were observed before and 7 days after treatment, and the changes of scores and indexes were compared between the two groups before and after treatment. Results the results of statistical analysis were performed with SPSS 19.0 software. Results: according to VAS score, Lysholm score, serum uric acid, C-reactive protein, erythrocyte sedimentation rate, the results showed that the treatment of knee joint gouty arthritis with minimally invasive needle knife and endoscope was more effective than that with drugs alone. There were significant differences in VAS score, C-reactive protein, erythrocyte sedimentation rate and Lysholm score between the two groups before and after treatment (P0.05), while the changes of serum uric acid in the control group were statistically significant before and after treatment (P0.05). There was no significant difference in serum uric acid between groups before and after treatment (P0.05). The results of follow-up showed that the recurrence frequency of the treatment group was better than that of the control group. Conclusion: the combination of minimally invasive needle knife and endoscope and medicine alone can relieve the pain, swelling, improve the function of knee joint and decrease the index of acute inflammation in patients with knee joint gouty arthritis. Minimally invasive needle knife endoscope can relieve pain more quickly, promote knee function improvement, and reduce recurrence rate more effectively. It is a safe, effective, easy to operate and quick functional recovery method compared with drug therapy alone. It is worth further popularizing and applying.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.9

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