摘要
目的 探究关节镜下射频消融治疗关节创伤性滑膜炎患者的疗效以及对膝关节功能和炎症水平的影响.方法 前瞻性选取2019年6月至2023年6月太原钢铁(集团)有限公司总医院收治的关节创伤性滑膜炎患者80例,按照随机数字表法将其分为研究组与对照组,每组各40例.对照组行关节镜下手术治疗,研究组行关节镜下射频消融术治疗.比较两组术后1个月时患者的治疗效果,并比较术后2周、1个月、3个月、6个月时Lysholm膝关节功能评分、疼痛情况[视觉模拟评分法(VAS)评分],术后2周的炎症因子[白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)]变化情况及患者的并发症发生情况.结果 术后1个月,研究组患者的治疗有效率为97.50％,高于对照组(85.00％),差异有统计学意义(P＜0.05).研究组术后2周、1个月、3个月、6个月的Lysholm膝关节功能评分分别为(40.87±2.34)、(55.79±2.12)、(65.87±1.99)、(75.64±2.18)、(81.02±2.64)分,均高于对照组[(40.22±2.16)、(50.88±2.45)、(60.22±2.13)、(68.46±2.49)、(75.46±2.11)分],差异均有统计学意义(P＜0.05).研究组患者术后 2周、1 个月、3 个月、6 个月的 VAS 评分分别为(6.88±1.05)、(4.05±0.51)、(3.46±0.38)、(2.67±0.18)、(2.02±0.15)分,均低于对照组[(6.78±1.22)、(4.89±0.64)、(4.02±0.34)、(3.56±0.21)、(2.46±0.22)分],差异均有统计学意义(P＜0.05).研究组患者术后 2 周的 IL-6、TNF-α、IL-1β 水平分别为(12.33±6.11)pg/mL、(1.67±0.34)ng/mL、(4.03±1.12)pg/mL,均低于对照组[(18.66±5.12)pg/mL、(2.06±0.45)ng/mL、(5.77±1.02)pg/mL],差异均有统计学意义(P＜0.05).研究组患者的总并发症发生率与对照组比较(10.00％vs.17.50％),差异无统计学意义(P＞0.05).结论 关节镜下射频消融治疗对于关节创伤性滑膜炎患者,可以显著提高治疗的有效率,明显优化膝关节的功能状态,减轻炎症反应,有效缓解患者的疼痛情况.
Abstract
Objective To explore the efficacy of radiofrequency ablation under arthroscope in the treatment of patients with traumatic syn-ovitis of the joints and its effect on knee joint function and inflammation level.Methods A total of 80 patients with traumatic synovitis of the joints admitted to Taiyuan Iron and Steel(Group)Co.,LTD.General Hospital from June 2019 to June 2023 were prospectively selected and di-vided into the study group and the control group according to the random number table method,with 40 cases in each group.The control group re-ceived arthroscopic surgery,and the study group received arthroscopic radiofrequency ablation.The treatment effects 1 month of after surgery of the two groups was compared,and the changes of Lysholm knee function score,pain[visual analogue scale(VAS)score]at 2 weeks,1 month,3 months,and 6 months of after surgery,inflammatory factors[interleukin(IL)-6,IL-1 β,tumor necrosis factor-α(TNF-α)]at 2 weeks of after surgery,and the complications of the two groups were compared.Results At 1 month after surgery,the response rate of the study group was 97.50％,which was higher than that in the control group(85.00％),the difference was statistically significant(P＜0.05).The Lysholm knee function scores of the study group at 2 weeks,1 month,3 months,and 6 months after surgery were(40.87±2.34),(55.79±2.12),(65.87±1.99),(75.64±2.18),(81.02±2.64)points,which were higher than those in the control group[(40.22±2.16),(50.88±2.45),(60.22±2.13),(68.46±2.49),(75.46±2.11)points],the differences were statistically significant(P＜0.05).The VAS scores of the study group at 2 weeks,1 month,3 months and 6 months after surgery were(6.88±1.05),(4.05±0.51),(3.46±0.38),(2.67±0.18)and(2.02±0.15)points,respectively,which were lower than those of the control group[(6.78±1.22),(4.89±0.64),(4.02±0.34),(3.56±0.21),(2.46±0.22)points],the differences were statistically significant(P＜0.05).The levels of IL-6,TNF-α and IL-1 β in the study group at 2 weeks after surgery were(12.33±6.11)pg/mL,(1.67±0.34)ng/mL and(4.03±1.12)pg/mL,respectively,which were lower than those in the control group[(18.66±5.12)pg/mL,(2.06±0.45)ng/mL,(5.77±1.02)pg/mL],the differences were sta-tistically significant(P＜0.05).There was no statistically significant difference in the incidence of total complications between the study group and the control group(10.00％vs.17.50％)(P＞0.05).Conclusion For patients with traumatic synovitis of the joints,radiofrequency abla-tion under arthroscopy can significantly improve the effective rate of treatment,significantly optimize the functional status of the knee joint,effec-tively relieve the pain of patients,and alleviate the inflammatory response of patients.
维普
万方数据