| 张计成,胡宗元,杨颖,等.膝关节封闭试验在拟行膝骨关节炎微创术治疗中的应用[J].安徽医药,2020,24(4):692-695. |
| 膝关节封闭试验在拟行膝骨关节炎微创术治疗中的应用 |
| Application of knee joint seal test in the minimally invasive treatment of knee osteoarthritis |
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| DOI：10.3969/j.issn.1009?6469.2020.04.014 |
| 中文关键词: 骨关节炎，膝 关节镜检查 疼痛测定 封闭试验 |
| 英文关键词: Osteoarthritis,knee Arthroscopy Pain measurement Closed test |
| 基金项目:河北省保定市科学研究与发展指导计划科技支撑计划( 16ZF013) |
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| 中文摘要: |
| 目的探讨封闭试验与拟行膝关节镜微创术治疗膝骨关节炎疗效的相关性，进而为膝关节镜手术适应证的选择、评估及提高手术疗效等提供理论依据。方法选择 2012年 1月至 2015年 12月在安国市医院骨科就诊的 100例膝骨关节炎病人，所有病人均因膝关节病变施行膝关节镜微创术，术后病理均证实排除恶性病变。术前对所有入选病人予以膝关节封闭试验，根据病人封闭指数(以 50%为界)分为封闭有效组和封闭无效组，分别记录封闭试验前后的视觉模拟评分法( VAS)评分、手术前后的 VAS评分、术后 1月随访时的 VAS评分及病人术后满意度调查，行封闭指数与 VAS评分相关性分析。结果(1)封闭试验后，封闭有效组 84例(占比 84.0%)封闭无效组 16例(占比 16.0%)。(2)同一组病人封闭试验前后、手术前后［(8.13±1.52)和(2.06±1.56)；(8.02±1.52)和( 5.14±1、术前和术后 1月随访时的 VAS评分［(8.13±1.52)和( 2.02±0.57)；(8.02±1.52)和( 3.07± .59)］，0.87)］及病人的满意度对比差异有统计学意义( P＜0.05)。(3)封闭指数与术后 VAS评分相关性分析结显示:封闭指数与术后 3d及 1月 VAS评分二者均呈负相关， R2分别为 0.552 5和 0.420 5，均 P＜0.05。另外，两组术后 3d的 VAS评分、术后 1月随访时的 VAS评分对比，差异有统计学意义( P＜0.05)。结论对于膝骨关节炎的病人，膝关节封闭试验结合 VAS评分可以帮助外科医生鉴别膝关节疼痛的来源，严格把握手术适应证。可以帮助外科医生评估膝关节镜微创术的术后疗效、提高手术效果，提高病人的接受度和满意度。 |
| 英文摘要: |
| Objective To explore the correlation between the closed test and the curative effect of knee arthroscopic minimally in?vasive surgery for knee osteoarthritis，and to provide theoretical basis for the selection of knee arthroscopy indications，evaluation and improvement of the surgical treatment.Methods One hundredpatients with knee osteoarthritis who were treated in theDepart? ment ofOrthopedic，Anguo Hospital，from January 2012 to December 2015 were enrolled.All patients underwent knee arthroscopyminimally invasive surgery for knee joint disease.Postoperative pathology confirmed the exclusion of malignant lesions.All patientsreceived the knee joint closed test before operation.According to the patient closure index(based on 50%)，they were assigned into closed effective group and closed ineffective group.The Visual Analogue Scale(VAS)scores before and after the closed test，before and after surgery，VAS scores at 1 month follow?upand postoperative satisfaction surveys were all recorded.The correlation analysis?between the closure index and VAS score was analyzed.Finally，the data obtained were statistically analyzed.Results(1)After the closed test，there were 84 cases(14.0%)in the closed effective group and 16 cases(16.0%)in the closed ineffective group.(2)There was significant difference on VAS scores in the closed effective group between before surgery and 3 days after surgery［(8.13±1.52)vs.(2.06±1.56)］，andbefore surgery and1 month after surgery［(8.13±1.52)vs.(2.02±0.57)］VAS scores have sig? nificant difference in the closed ineffective group between before surgery and 3 days after surgery［(8.02±1.52)，vs.(5.14±1.59)］， and before surgery and 1 month after surgery［(8.02±1.52)vs.(2.02±0.57)］，and patient satisfaction have significant difference in the two groups(all P＜0.05).en the occlusion index and the postoperative VAS(3)The results of the correlation analysis betwescore showed that the occlusion index was negatively correlated with the postoperative VAS score 3 days and 1 month after the op?eration，with R2 of 0.552 5 and 0.420 5，respectively，and P＜0.05.In addition，VAS scores were statistically differencebetween3 days after operation and1 month follow?up(P＜0.05).Conclusions For patients with knee arthritis，the knee joint closure test com? bined with the VAS score can help the surgeon identify the source of knee pain and strictly grasp the surgical indications.It can al?so help to evaluate the postoperative efficacy of knee arthroscopy minimally invasive surgery，improve the surgical results，improvepatient acceptance and satisfaction. |
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