[1]邓伟哲,王宏晶,王宇恒,等.微创针刀镜治疗难治性膝关节类风湿关节炎[J].中医正骨,2015,27(11):42-44.
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微创针刀镜治疗难治性膝关节类风湿关节炎()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期数:
2015年11期
页码:
42-44
栏目:
临床报道
出版日期:
2015-11-30

文章信息/Info

作者:
邓伟哲1王宏晶2王宇恒1王宇光1张筠1姜宜惠1李春雷1魏博1刘晓萌1秦玉雪2
1.中国人民解放军第二一一医院,黑龙江 哈尔滨 150080;
2.黑龙江中医药大学,黑龙江 哈尔滨 150040
关键词:
关节炎类风湿 膝关节 外科手术微创性 针刀镜
摘要:
目的:观察微创针刀镜治疗难治性膝关节类风湿关节炎的临床疗效和安全性。方法:2014年1—12月,采用微创针刀镜治疗难治性膝关节类风湿关节炎患者20例,男1例、女19例。年龄27~74岁,中位数49.5岁。所有患者左膝关节症状较显著。术后随访观察病情改善、并发症发生及患肢功能恢复情况。结果:手术时间20~50 min,中位数30 min。术后4周,患者对疾病自我评分、医生对疾病评分、患者对疼痛评分、健康调查问卷评分均低于术前[(4.70±1.07)分,(7.65±1.42)分,t=10.927,P=0.043;(3.40±0.94)分,(7.80±1.32)分,t=12.130,P=0.048;(3.80±0.89)分,(7.35±1.35)分,t=9.811,P=0.035;(1.25±0.29)分,(2.65±0.17)分,t=18.404,P=0.040]; 晨僵时间短于术前[(21.65±3.45)min,(51.15±12.15)min,t=5.054,P=0.001]; 关节压痛数与关节肿胀数少于术前[(10.15±2.58)个,(18.90±4.36)个,t=7.719,P=0.014;(9.90±1.65)个,(18.05±2.41)个,t=12.453,P=0.037]; 血清C反应蛋白及血沉水平低于术前[(1.57±1.25)mg·L-1,(4.85±3.55)mg·L-1,t=6.205,P=0.001;(29.60±19.70)mm·h-1,(76.35±32.66)mm·h-1,t=6.133,P=0.001]。均未出现感染等并发症。参照美国风湿病学会(American college of rheumatology,ACR)制定的疗效评价标准ACR20、ACR50、ACR70评价疗效,临床缓解2例、显效14例、有效4例。结论:采用微创针刀镜治疗难治性膝关节类风湿关节炎,创伤小,能够缓解膝关节疼痛和肿胀,减轻膝关节炎症,有利于恢复患肢功能,提高患者生活质量,并发症少,值得临床推广应用。

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备注/Memo

备注/Memo:
2015-07-03收稿 2015-09-02修回
通讯作者:邓伟哲 E-mail:deng-wz@163.com
更新日期/Last Update: 2015-11-30