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超声引导下针刀松解联合脉冲射频治疗膝骨关节炎患者的效果

Efficacy of ultrasound-guided acupotomy combined with pulsed radiofrequency in the treatment of patients with knee osteoarthritis
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摘要 目的比较超声引导下针刀松解联合脉冲射频治疗与单纯超声引导下针刀松解术对于膝骨关节炎的治疗效果,探讨脉冲射频治疗的应用价值。方法将2017年6月至2018年6月上海复旦大学附属华东医院疼痛科和南通市第六人民医院疼痛科收治的膝骨关节炎患者54例随机分为两组,单纯组28例,采用超声引导下针刀松解术,联合组26例,釆用超声引导下针刀松解联合脉冲射频治疗.依据两组患者治疗前及治疗后1、6个月时的视觉模拟评分(VAS).Lysholm膝关节功能评分.以及健康调查简易量表(SF-36)来进行疗效的评价。结果两组患者治疗后1、6个月时的VAS评分均较各组治疗前降低.差异有统计学意义(P<0.05);两组治疗后1、6个月时的Lysholm和SF-36评分均较各组治疗前升高,差异有统计学意义(P<0.05)。联合组治疗后1个月时VAS评分较同一时间点单纯组低,差异有统计学意义(P<0.05);治疗后1个月时SF-36评分较同一时点单纯组高,差异有统计学意义(P<0.05);而治疗后6个月时VAS和SF-36评分两组差异均无统计学意义(P > 0.05 ),联合组治疗后1、6个月时Lysholm评分均较同一时间点单纯组高,差异有统计学意义(P<0.05)所有患者均未见膝关节感染、血管、神经损伤等并发症。结论超声引导下针刀松解联合脉冲射频治疗和单纯超声引导下针刀松解术对于膝骨关节炎的患者均有疗效,前者对于改善膝关节功能的效果更佳. Objective To observe and compare the therapeutic effects of ultrasound-guided acupotomy combined with pulsed radiofrequency and ultrasound-guided acupotomy alone on knee osteoarthritis, and to explore the application value of pulsed radiofrequency. Methods Fifty-four patients with knee osteoarthritis were randomly divided into two groups, 28 patients in the simple group and 26 patients in the combined group, from June 2017 to June 2018 in East China Hospital Affiliated to Shanghai Fudan University and the Sixth People's Hospital of Nantong. The patients were treated with only ultrasound-guided acupotomy in the simple group, and ultrasound-guided acupotomy combined with pulsed radiofrequency in the combined group. Visual analogue scale (VAS), Lysholm knee function score (Lysholm) and SF-36 score were used to assess the effects before the treatment and at 1 month and 6 months after the treatment. Results VAS was lower in the two groups after the treatment than that before the treatment PvO.01), and the Lysholm and SF-36 scores were higher in the two groups after the treatment than those before the treatment ( P<0.01 ). One month after the treatment, the V AS was even lower in the combined group than that in the simple group(P<0.05), while the SF-36 score was even higher in the combined group than that in the simple group at the same time point (P<0.05). There was no significant difference for VAS and SF-36 scores between the two groups at 6 months after the treatment. The Lvsholm score was higher in the combined group than that in the simple group at the same time point at 1 and 6 months after the treatment with statistical significance( P<0.05). No obvious complications such as infection and vessels / nerve injury were found. Conclusion Both ultrasound-guided acupotomy combined with pulsed radiofrequency and ultrasound-guided acupotomy alone are effective in the treatment of patients with knee osteoarthritis, while the former is better in improving the function of knee joints.
作者 谢南海 沈薇 郑拥军 Xie Nanhai;Shen Wei;Zheng Yongjun(Department of Pain Management, the Sixth People's Hospital of Nantong, Jiangsu Province 226001,China;Department of Pain Medicine, East China Hospital Affiliated to Fudan University, Shanghai 200040,China)
出处 《实用疼痛学杂志》 2019年第1期47-52,共6页 Pain Clinic Journal
基金 2017年度南通市市级科技计划(指导性)项目(GJZ17O7O) 上海市科学技术委员会科研项目计划(课题)(15DZ1940104) 上海市卫生利计划生育委员会面上项目(201540297).
关键词 脉冲射频 骨关节炎.膝:超声检査.多普勒:小刀针 Pulsed radiofrequency Osteoarthritis, knee Ultrasonography, floppier Small knife needle
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