首页|超声引导下隐神经脉冲射频治疗膝骨性关节炎伴心血管疾病的效果及安全性评价

超声引导下隐神经脉冲射频治疗膝骨性关节炎伴心血管疾病的效果及安全性评价

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目的 综合评价隐神经脉冲射频治疗膝骨性关节炎(KOA)伴心血管疾病(CVD)的临床效果及安全性。方法 选取2022年3月至2024年2月西安交通大学第一附属医院收治的132例KOA伴CVD患者,按照随机数字表法分为两组,A组(65例)行超声引导下隐神经脉冲射频治疗,B组(67例)口服依托考昔片+关节腔内注射玻璃酸钠,记录两组患者年龄、性别、身高、体重、BMI、膝关节功能分级(K-L分级)、心血管疾病种类分布等基础资料,比较两组治疗后1周、1个月、3个月、6个月膝关节疼痛程度[视觉模拟量表(VAS)评分]、膝关节功能评分(OKS)和雅典失眠量表(AIS)评分及并发症情况。结果 A组VAS评分从治疗后1周到治疗后6个月,呈缓缓下降的趋势。B组治疗后1周VAS评分降至最低,在治疗后6个月内逐渐升高。两组VAS评分在治疗1周,治疗1、3、6个月均较治疗前有改善(F=703。955,P<0。001),且A组各时点疼痛改善程度优于B组(F=106。575,P<0。001)。两组患者治疗1周,治疗1、3、6个月OKS均较术前下降明显,时间效应有统计学意义(F=2 233。447,P<0。001)。A组治疗1周,治疗1、3、6个月的OKS均低于B组,差异有统计学意义(F=141。214,P<0。001)。两组治疗l周,治疗1、3、6个月AIS评分均较术前改善(F=1 044。424,P<0。001),且 A组治疗1、3、6个月AIS评分优于B组,差异有统计学意义(F=124。864,P<0。001)。两组术后并发症比较差异无统计学意义(P>0。05)。结论 超声引导下隐神经脉冲射频治疗KOA伴CVD可显著缓解术后疼痛、改善关节活动能力及睡眠质量,效果优于口服依托考昔片加关节腔注射玻璃酸钠的传统保守治疗。
Evaluation of the efficacy and safety of ultrasound-guided pulsed radiofrequency treatment for knee osteoarthritis in patients with cardiovascular disease
Objective To comprehensively evaluate the clinical efficacy and safety of pulse radiofrequency therapy for knee osteoarthritis(KOA)with cardiovascular disease(CVD).Methods A total of 132 patients with knee osteoarthritis(KOA)and cardiovascular disease(CVD)admitted to the First Affiliated Hospital of Xi'an Jiaotong University from March 2022 to February 2024 were randomly divided into two groups using a random number table method.Group A(65 cases)received ultrasound-guided pulse radiofrequency treatment of the hidden nerve,while group B(67 cases)received oral etoposide tablets and intra-articular injection of sodium hyaluronate.Basic data such as age,gender,height,weight,body mass index(BMI),knee joint function grading(K-L grading),and distribution of cardiovascular disease types were recorded between the two groups.The degree of knee joint pain[Visual Analog Scale(VAS)score]and Knee Joint Function Score(OKS),Athens Insomnia Scale(AIS)scores and incidence of complications.were compared between the two groups at 1 week,1 month,3 months,and 6 months after treatment.Results The VAS score of group A showed a slow decreasing trend from 1 week to 6 months after treatment.The VAS score of group B decreased to the lowest level one week after treatment and gradually increased within 6 months after treatment.The VAS scores of both groups improved after 1 week of treatment and at l,3,and 6 months of treatment compared to preoperative levels(F=703.955,P<0.001),and the degree of postoperative pain improvement in the group A was better than that in the group B(F=106.575,P<0.001).The OKS of both groups decreased significantly after 1 week of treatment and at 1,3,and 6 months of treatment,and the time effect was statistically significant(F=2 233.447,P<0.001).The OKS of the group A was lower than that of group B after 1 week of treatment and at 1,3,and 6 months of treatment,and the difference was statistically significant(F=141.214,P<0.001).The AIS scores improved significantly after 6 months of treatment compared to preoperative levels(F=1 044.424,P<0.001),and the group A had better AIS scores than the group B at 1,3,and 6 months of treatment,with statistically significant differences(F=124.864,P<0.001).There was no statistically significant difference in postoperative complications between the two groups(P>0.05).Conclusions Ultrasound guided pulsed radiofrequency treatment of KOA with CVD can significantly alleviate postoperative pain,improve joint mobility and sleep quality,and is more effective than traditional conservative treatment of oral etoposide tablets combined with intra-articular injection of sodium hyaluronate.

Osteoarthritis,kneeCardiovascular diseasesPulsed radiofrequency treatmentSaphenous nerve

张丹丹、王锁良、聂会勇、任延平、王诗雨、闫芍药

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西安交通大学第一附属医院老年内一科,西安 710061

西安交通大学第一附属医院疼痛科,西安 710061

骨关节炎,膝 心血管疾病 脉冲射频术 隐神经

2024

中国医师杂志
中华医学会 湖南省医学会

中国医师杂志

CSTPCD
影响因子:0.876
ISSN:1008-1372
年,卷(期):2024.26(9)