论文部分内容阅读
[目的]探讨关节镜联合康复支具治疗膝关节骨性关节炎 (KOA)的临床疗效及对炎性因子水平的影响.[方法]选取2015年10月至2017年8月本院收治的KOA86例,按照随机数表分为观察组和对照组,每组43例.对照组采用单独关节镜治疗,观察组在对照组基础上联合康复支具治疗.比较两组患者临床疗效及治疗前后两组患者视觉模拟评分法(VAS)评分、LyshoLm膝关节功能评分、KOA症状体征评分、血清一氧化氮(NO)、白介素6(IL-6)、基质金属蛋白3(MMP-3)、血管内皮生长因子(VEGF)水平变化情况.[结果]观察组总有效率为90.7%(39／43),显著高于对照组的72.1%(31／43),其差异具有统计学意义(χ2=4.914,P=0.048).两组患者治疗后VAS疼痛评分、LyshoLm膝关节功能评分及KOA症状体征评分均较治疗前显著改善,且观察组改善效果更为明显(P<0.05);治疗后,两组患者血清NO、IL-6、MMP-3及VEGF水平均显著低于治疗前,且观察组各项指标水平均显著低于对照组(P<0.05).[结论]关节镜联合康复支具治疗KOA效果显著,可促进患者膝关节功能的恢复,缓解疼痛症状,并能抑制炎症因子的表达,值得 临床推广应用.“,”[Objective]ToinvestigatethecLinicaLeffectofarthroscopycombinedwithrehabiLitationsupportinthe treatmentofkneeosteoarthritis(KOA)anditseffectoninfLammatoryfactors.[Methods]Eighty-sixcasesofKOA from October2015toAugust2017weredividedintoobservationgroup(n=43)andcontroLgroup(n=43).The controLgroupwastreatedbyarthroscopyaLone,whiLetheobservationgroupwastreatedwithrehabiLitationsupport onthebasisofthecontroLgroup.ThecLinicaLefficacyandvisuaLanaLoguescore (VAS),LyshoLm kneefunction score,KOAsymptomandsignscore,serumnitricoxide(NO),interLeukin-6 (IL-6)werecomparedbetweenthe twogroupsbeforeandaftertreatment.ChangesofmatrixmetaLLoprotein3(MMP-3)andvascuLarendotheLiaLgrowth factor(VEGF)LeveLs.[ResuLts]ThetotaLeffectiverateoftheobservationgroupwas90.7% (39／43),whichwassig-nificantLyhigherthanthatofthecontroLgroup72.1% (31／43)(χ2=4.914,P=0.048).Aftertreatment,VASpain score,LyshoLmkneefunctionscoreandKOAsymptomandsignscoreweresignificantLyimprovedinbothgroups, andtheeffectwasmoreobviousintheobservationgroup(P<0.05).Aftertreatment,theLeveLsofserum NO,IL-6,MMP-3andVEGFinthetwogroupsweresignificantLyLowerthanthosebeforetreatment,andtheLeveLsofeach indexintheobservationgroupweresignificantLyLowerthanthoseinthecontroLgroup(P<0.05).[ConcLusion]Ar-throscopycombinedwithrehabiLitationsupportiseffectiveinthetreatmentofKOA,whichcanpromotetherecovery ofkneejointfunction,reLievepainsymptoms,andinhibittheexpressionofinfLammatoryfactors,whichisworth popuLarizingincLinic.