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[1]彭德強(qiáng),王思雨,李健,等.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉注射治療半月板損傷的Meta分析[J].中醫(yī)正骨,2022,34(11):18-26.
　PENG Deqiang,WANG Siyu,LI Jian,et al.Arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury:a meta-analysis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(11):18-26.
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關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉注射治療半月板損傷的Meta分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第34卷
期數(shù):
2022年11期
頁(yè)碼:
18-26
欄目:
文獻(xiàn)研究
出版日期:
2022-11-11

文章信息/Info

Title:
Arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury:a meta-analysis
作者:
彭德強(qiáng)1; 王思雨2; 李健1; 楊美平1; 牛維3
(1.廣州中醫(yī)藥大學(xué)第二臨床醫(yī)學(xué)院,廣東 廣州 510405; 2.湖南中醫(yī)藥大學(xué),湖南 長(zhǎng)沙 410208; 3.廣東省中醫(yī)院,廣東 廣州 510120)
Author(s):
PENG Deqiang1; WANG Siyu2; LI Jian1; YANG Meiping1; NIU Wei3
1.The Second Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong,China2.Hunan University of Chinese Medicine,Changsha 410208,Hunan,China3.Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,Guangdong,China
關(guān)鍵詞:
膝損傷;  半月板;  關(guān)節(jié)鏡檢查;  透明質(zhì)酸;  專題Meta分析
Keywords:
knee injuries;  meniscus;  arthroscopy;  hyaluronic acid;  Meta-analysis as topic
摘要:
目的:評(píng)價(jià)關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉注射治療半月板損傷的臨床療效和安全性。方法:計(jì)算機(jī)檢索中國(guó)知網(wǎng)、維普網(wǎng)、萬(wàn)方數(shù)據(jù)庫(kù)、PubMed、Embase、Cochrane Library中關(guān)于關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉注射治療半月板損傷的臨床隨機(jī)對(duì)照研究文獻(xiàn),檢索時(shí)限為建庫(kù)至2021年4月,聯(lián)合組干預(yù)措施為關(guān)節(jié)鏡手術(shù)聯(lián)合術(shù)后關(guān)節(jié)腔內(nèi)玻璃酸鈉注射,對(duì)照組干預(yù)措施為單純關(guān)節(jié)鏡手術(shù)。由2名研究者獨(dú)立根據(jù)文獻(xiàn)納排標(biāo)準(zhǔn)篩選文獻(xiàn),并提取第一作者姓名、文獻(xiàn)發(fā)表年份、研究樣本量、研究對(duì)象性別、結(jié)局指標(biāo)等數(shù)據(jù)。結(jié)局指標(biāo)包括治療有效率、Lysholm膝關(guān)節(jié)評(píng)分、膝關(guān)節(jié)疼痛視覺模擬量表(visual analogue scale,VAS)評(píng)分、膝關(guān)節(jié)活動(dòng)度、國(guó)際膝關(guān)節(jié)文獻(xiàn)委員會(huì)(International Knee Documentation Committee,IKDC)膝關(guān)節(jié)評(píng)分、不良反應(yīng)發(fā)生率、患者滿意度。采用Cochrane偏倚風(fēng)險(xiǎn)評(píng)估工具對(duì)納入文獻(xiàn)進(jìn)行質(zhì)量評(píng)價(jià),采用RevMan5.3軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。結(jié)果:經(jīng)過篩選最終納入文獻(xiàn)25篇,其中中文文獻(xiàn)21篇、英文文獻(xiàn)4篇。Meta分析結(jié)果示,聯(lián)合組的治療有效率、Lysholm膝關(guān)節(jié)評(píng)分、患者滿意度均高于對(duì)照組[OR=5.63,95%CI(3.72,8.52),P=0.000; MD=11.39,95%CI(10.46,12.32),P=0.000; OR=3.94,95%CI(1.61,9.60),P=0.003]; 聯(lián)合組的膝關(guān)節(jié)活動(dòng)度優(yōu)于對(duì)照組[MD=12.31,95%CI(11.52,13.10),P=0.000]; 聯(lián)合組的膝關(guān)節(jié)疼痛VAS評(píng)分、不良反應(yīng)發(fā)生率均低于對(duì)照組[MD=-0.69,95%CI(-0.87,-0.52),P=0.000; OR=0.47,95%CI(0.26,0.86),P=0.010]; 2組IKDC膝關(guān)節(jié)評(píng)分的差異無統(tǒng)計(jì)學(xué)意義[MD=6.27,95%CI(-10.72,23.26),P=0.470]。結(jié)論:關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉注射治療半月板損傷,與單純關(guān)節(jié)鏡手術(shù)相比,在緩解術(shù)后疼痛和促進(jìn)膝關(guān)節(jié)功能恢復(fù)方面更有優(yōu)勢(shì),綜合療效更好,安全性更高,患者更滿意。
Abstract:
Objective:To evaluate the clinical efficacy and safety of arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury.Methods:All the randomized controlled trial(RCT)articles about arthroscopic surgery combined with hyaluronic acid injection for treatment of meniscus injury included from database establishing to April,2021 were retrieved from the China National Knowledge Internet,Vip Database,Wanfang Database,PubMed,Embase and Cochrane Library through computer.The patients in combined group were treated with arthroscopic surgery and postoperative intra-articular hyaluronic acid injection,while the ones in control group with arthroscopic surgery alone.The articles were screened by two researchers independently according to the inclusion and exclusion criteria.The first author's name,publication year,sample size,gender of subjects,outcome indicators and other data was extracted.Outcome measures included effective rate,Lysholm knee score,knee pain visual analogue scale(VAS)score,knee range of motion,International Knee Documentation Committee(IKDC)score,incidence of adverse effects,patient satisfaction.The quality of the included articles was evaluated by using Cochrane bias risk assessment tool and then a Meta-analysis was conducted by using RevMan 5.3 software.Results:After screening,25 articles were included,including 21 Chinese articles and 4 English articles.The results of meta-analysis revealed that the effective rate,Lysholm knee scores and patient satisfaction were higher in combined group compared to control group(OR=5.63,95%CI(3.72,8.52),P=0.000; MD=11.39,95%CI(10.46,12.32),P=0.000; OR=3.94,95%CI(1.61,9.60),P=0.003).The knee range of motion was better in combined group compared to control group(MD=12.31,95%CI(11.52,13.10),P=0.000).The VAS scores and incidence of adverse effects were lower in combined group compared to control group(MD=-0.69,95%CI(-0.87,-0.52),P=0.000; OR=0.47,95%CI(0.26,0.86),P=0.010).There was no statistical difference in IKDC scores between the 2 groups(MD=6.27,95%CI(-10.72,23.26),P=0.470).Conclusion:Arthroscopic surgery combined with hyaluronic acid injection in treatment of meniscus injury displays advantages as more likely to alleviate postoperative knee pain and promote the recovery of knee function,better comprehensive efficacy,higher safety and patient satisfaction compared to arthroscopic surgery alone.

參考文獻(xiàn)/References:

[1] 顧軍,王睿,孔曉海,等.關(guān)節(jié)鏡下Fast-Fix半月板縫合術(shù)治療膝關(guān)節(jié)外側(cè)盤狀半月板損傷[J].中國(guó)矯形外科雜志,2017,25(22):2093-2096.
[2] AMANO H,IWAHASHI T,SUZUKI T,et al.Analysis of displacement and deformation of the medial meniscus with a horizontal tear using a three-dimensional computer model[J].Knee Surg Sports Traumatol Arthrosc,2015,23(4):1153-1160.
[3] DEMANGE M K,GOBBI R G,CAMANHO G L.“Fatigue meniscal tears”:a description of the lesion and the results of arthroscopic partial meniscectomy[J].Int Orthop,2016,40(2):399-405.
[4] 劉登華,周愛國(guó).外側(cè)盤狀半月板損傷及治療與膝關(guān)節(jié)骨關(guān)節(jié)炎的關(guān)系[J].中國(guó)骨與關(guān)節(jié)損傷雜志,2022,37(1):109-111.
[5] ZHANG X,YOU T,JIANG X,et al.Characteristic arthroscopic signs of cartilage injuries indicating concomitant occult medial meniscal peripheral tears of posterior horn[J].Int Orthop,2016,40(1):191-195.
[6] KAMAL Y,KHAN H A,LATOO I A,et al.Squat winnowing:cause of meniscus injuries in non-athletic females[J].Trauma Mon,2016,21(1):e19178.
[7] 劉玉.實(shí)用關(guān)節(jié)鏡手術(shù)學(xué)[M].北京:化學(xué)工業(yè)出版社,2018:41-43.
[8] 馬銳祥,孔榮,朱晨,等.關(guān)節(jié)鏡配合玻璃酸鈉注射液關(guān)節(jié)腔內(nèi)注射治療半月板損傷的臨床觀察[J].中華骨與關(guān)節(jié)外科雜志,2016,9(3):209-212.
[9] MATHIES B.Effects of Viscoseal,a synovial fluid substitute,on recovery after arthroscopic partial meniscectomy and joint lavage[J].Knee Surg Sports Traumatol Arthrosc,2006,14(1):32-39.
[10] FILARDO G,MATTEO B D,TENTONI F,et al.No effects of early viscosupplementation after arthroscopic partial meniscectomy:a randomized controlled trial[J].Am J Sports Med,2016,44(12):3119-3125.
[11] DE PAULA PEREIRA JUNIOR A,FASOLIN R P,SOSSA F A C,et al.Results evaluation of the use of intra-articular sodium hyaluronate in the post-operative knee arthroscopy[J].Rev Bras Ortop,2014,49(1):37-43.
[12] WESTRICH G,SCHAEFER S,WALCOTT-SAPP S,et al.Randomized prospective evaluation of adjuvant hyaluronic acid therapy administered after knee arthroscopy[J].Am J Orthop(Belle Mead NJ),2009,38(12):612-616.
[13] 張亮,張憲,周偉,等.半月板損傷患者關(guān)節(jié)鏡術(shù)后注射玻璃酸鈉效果研究[J].中華臨床醫(yī)師雜志(電子版),2013,7(7):3185-3187.
[14] 劉巖.關(guān)節(jié)鏡術(shù)后玻璃酸鈉關(guān)節(jié)內(nèi)注射治療半月板損傷伴骨關(guān)節(jié)炎的效果[J].中外醫(yī)學(xué)研究,2016,14(35):147-148.
[15] 廖永平,彭琴香,彭小琴.膝關(guān)節(jié)鏡聯(lián)合玻璃酸鈉關(guān)節(jié)腔注射治療102例半月板損傷的臨床療效觀察[J].當(dāng)代醫(yī)學(xué),2017,23(26):17-19.
[16] 王長(zhǎng)明.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療半月板損傷臨床療效觀察[J].心理月刊,2019,14(14):212.
[17] 冉單.關(guān)節(jié)鏡術(shù)后玻璃酸鈉關(guān)節(jié)內(nèi)注射治療半月板損傷伴骨關(guān)節(jié)炎的療效[J].世界最新醫(yī)學(xué)信息文摘,2018,18(73):17-18.
[18] 周志明,丘天雄,鄭靈輝.關(guān)節(jié)鏡半月板成形術(shù)聯(lián)合玻璃酸鈉對(duì)膝關(guān)節(jié)半月板損傷患者膝關(guān)節(jié)活動(dòng)度及Lysholm、IKDC評(píng)分的影響[J].中外醫(yī)學(xué)研究,2021,19(2):48-50.
[19] 陳延軍,邢秀麗,霍三順.玻璃酸鈉注射聯(lián)合關(guān)節(jié)鏡手術(shù)治療半月板損傷[J].臨床骨科雜志,2017,20(5):571.
[20] 湯慶.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)給藥治療半月板損傷的臨床效果[J].臨床合理用藥雜志,2017,10(6):27-28.
[21] 王俊峰,樊盛,劉偉峰,等.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉腔內(nèi)注射治療半月板損傷的臨床效果觀察[J].中國(guó)民康醫(yī)學(xué),2018,30(9):24-25.
[22] 劉凱.膝關(guān)節(jié)鏡、玻璃酸鈉關(guān)節(jié)腔注射聯(lián)合治療半月板損傷的價(jià)值評(píng)估[J].中外醫(yī)療,2018,37(13):94-96.
[23] 許紅艷.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療半月板損傷的療效觀察[J].雙足與保健,2019,28(15):144-145.
[24] 陳明錚.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉腔內(nèi)注射治療半月板損傷的效果[J].中國(guó)醫(yī)藥科學(xué),2019,9(17):227-229.
[25] 劉俊陽(yáng),張卓,馬連君,等.關(guān)節(jié)鏡術(shù)后玻璃酸鈉關(guān)節(jié)內(nèi)注射治療半月板損傷伴骨關(guān)節(jié)炎的療效[J].中國(guó)老年學(xué)雜志,2012,32(23):5327-5328.
[26] 何文浩,李超.關(guān)節(jié)鏡術(shù)后關(guān)節(jié)內(nèi)注射玻璃酸鈉治療半月板損傷伴骨關(guān)節(jié)炎的療效評(píng)價(jià)[J].山西醫(yī)藥雜志,2019,48(10):1187-1189.
[27] 唐宏超.透明質(zhì)酸關(guān)節(jié)腔內(nèi)注射在半月板損傷關(guān)節(jié)鏡術(shù)后應(yīng)用效果[J].中國(guó)醫(yī)藥導(dǎo)報(bào),2015,12(33):117-120.
[28] 王翊.伴有半月板損傷早期骨關(guān)節(jié)炎行關(guān)節(jié)鏡治療與注射玻璃酸鈉保守的療效對(duì)比[J].臨床醫(yī)藥文獻(xiàn)電子雜志,2019,6(30):34.
[29] 楊鍇.關(guān)節(jié)鏡配合玻璃酸鈉注射液關(guān)節(jié)腔內(nèi)注射治療半月板損傷的臨床分析[J].中國(guó)實(shí)用醫(yī)藥,2015,10(34):69-70.
[30] 李瑩洲.膝關(guān)節(jié)鏡手術(shù)配合玻璃酸鈉關(guān)節(jié)腔注射治療半月板損傷32例療效觀察[J].醫(yī)學(xué)理論與實(shí)踐,2017,30(23):3511-3513.
[31] 丁英奇,劉英飛,李耀華,等.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療半月板損傷臨床療效觀察[J].疑難病雜志,2014,13(1):85-87.
[32] 第五勇剛,任文靜,羅新平,等.關(guān)節(jié)鏡術(shù)后玻璃酸鈉關(guān)節(jié)內(nèi)注射治療半月板損傷伴骨關(guān)節(jié)炎的效果[J].臨床醫(yī)學(xué)研究與實(shí)踐,2019,4(3):53-54.
[33] 黃霄漢.關(guān)節(jié)鏡手術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔內(nèi)注射治療半月板損傷的療效觀察[J].中國(guó)傷殘醫(yī)學(xué),2017,25(1):35-36.
[34] 倪華偉,李海波,范洪輝,等.微骨折術(shù)聯(lián)合玻璃酸鈉關(guān)節(jié)腔注射修復(fù)半月板損傷的療效觀察[J].中國(guó)骨與關(guān)節(jié)損傷雜志,2017,32(8):854-855..
[35] TANG J,JI M,LIAO Y M,et al.Arthroscopic all-inside suture repair combined with sodium hyaluronate injection for discoid meniscus injury[J].Chinese Journal of Tissue Engineering Research,2015,19(37):5943-5949.
[36] 馬志剛,郭立平,張建寧,等.不同分子質(zhì)量玻璃酸鈉注射骨關(guān)節(jié)炎兔關(guān)節(jié)液內(nèi)相關(guān)因子的變化[J].中國(guó)組織工程研究,2020,24(5):694-698.
[37] 潘正烽,林奕鵬,李棋.玻璃酸鈉分子量差異影響骨關(guān)節(jié)炎臨床治療獲益的效應(yīng)及機(jī)制分析[J].中華骨科雜志,2019,39(3):183-188.
(收稿日期:2022-01-05 本文編輯:楊雅)

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[3]王東莉.縫合錨釘內(nèi)固定治療髕骨下極撕脫性骨折[J].中醫(yī)正骨,2016,28(11):37.
[4]張遼,金甬,毛宇芳,等.髕旁小切口經(jīng)髕股關(guān)節(jié)通道加壓埋頭空心釘結(jié)合縫線錨釘內(nèi)固定治療前交叉韌帶脛骨止點(diǎn)撕脫骨折[J].中醫(yī)正骨,2016,28(11):43.
[5]徐向峰,王慶東,金艷南,等.關(guān)節(jié)鏡下可吸收螺釘內(nèi)固定治療髕骨骨軟骨骨折[J].中醫(yī)正骨,2016,28(12):65.
[6]李藝彬,朱勇,徐新強(qiáng),等.關(guān)節(jié)鏡下分型治療兒童和青少年外側(cè)盤狀半月板損傷[J].中醫(yī)正骨,2017,29(03):52.
[7]曾斌,吳旭東,黃小剛,等.腰托輔助膝關(guān)節(jié)外翻法在關(guān)節(jié)鏡下內(nèi)側(cè)半月板后角成形術(shù)中的應(yīng)用[J].中醫(yī)正骨,2017,29(03):58.
[8]金永鑫.關(guān)節(jié)鏡下半月板切除或縫合術(shù)治療外側(cè)半月板撕裂合并關(guān)節(jié)軟骨損傷[J].中醫(yī)正骨,2017,29(05):45.
[9]楊偉毅,潘建科,韓燕鴻,等.陳舊性前交叉韌帶損傷診治中需要注意的問題[J].中醫(yī)正骨,2017,29(08):48.
[10]權(quán)松濤,蔡利濤,楊明路.單枚外排錨釘結(jié)合Orthocord縫合線線橋內(nèi)固定治療后交叉韌帶脛骨止點(diǎn)撕脫骨折[J].中醫(yī)正骨,2017,29(09):52.
[11]蒙劍德,夏賢生,趙小泉,等.功能鍛煉聯(lián)合中藥薰蒸在膝關(guān)節(jié)半月板損傷關(guān)節(jié)鏡下 成形術(shù)后康復(fù)治療中的應(yīng)用[J].中醫(yī)正骨,2015,27(06):37.
[12]邵文飛.內(nèi)服四妙散加減配合功能鍛煉治療膝關(guān)節(jié)半月板損傷[J].中醫(yī)正骨,2015,27(06):39.
[13]張輝,莊萬(wàn)強(qiáng),魏慶華,等.關(guān)節(jié)鏡手術(shù)治療前交叉韌帶斷裂合并半月板損傷[J].中醫(yī)正骨,2018,30(07):56.
[14]曾斌,吳旭東,黃小剛,等.關(guān)節(jié)鏡下Healix帶線錨釘經(jīng)脛骨隧道縫合固定治療半月板撕裂[J].中醫(yī)正骨,2021,33(01):60.
[15]張文橋,沈烈軍,陳文鋒.關(guān)節(jié)鏡下經(jīng)脛骨隧道帶袢鋼板固定與常規(guī)錨釘固定治療內(nèi)側(cè)半月板后根部撕裂的比較研究[J].中醫(yī)正骨,2021,33(11):24.
　ZHANG Wenqiao,SHEN Liejun,CHEN Wenfeng.A comparative study of arthroscopic Endobutton plate fixation through tibial tunnel versus conventional arthroscopic suture anchor fixation for treatment of medial meniscus posterior root tear[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2021,33(11):24.
[16]劉輝,劉波,張?chǎng)?等.終末伸膝肌電生物反饋訓(xùn)練在半月板損傷非手術(shù)治療中的應(yīng)用價(jià)值[J].中醫(yī)正骨,2022,34(04):12.
　LIU Hui,LIU Bo,ZHANG Xin,et al.Applied values of terminal knee-extension electromyographic biofeedback training in nonsurgical treatment of meniscus injuries[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2022,34(11):12.
[17]陳鈺祥.磁共振定量磁化率成像在半月板變性和半月板撕裂診斷中的應(yīng)用價(jià)值[J].中醫(yī)正骨,2022,34(09):33.
[18]陳帥,嚴(yán)海霞,張宏藝,等.關(guān)節(jié)鏡下“川”字形三針全內(nèi)垂直縫合技術(shù)治療膝關(guān)節(jié)內(nèi)側(cè)半月板桶柄狀撕裂[J].中醫(yī)正骨,2023,35(03):73.
[19]袁祥生,周紅星.關(guān)節(jié)鏡下半月板成形縫合術(shù)與半月板部分切除術(shù)治療單純半月板撕裂傷的比較研究[J].中醫(yī)正骨,2023,35(04):12.
　YUAN Xiangsheng,ZHOU Hongxing.A comparative study of arthroscopic meniscal suture versus partial meniscectomy in the treatment of simple meniscal laceration[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(11):12.
[20]葉子揚(yáng),葉秀云,胡艇.前交叉韌帶斷裂合并半月板撕裂的解剖學(xué)影響因素分析[J].中醫(yī)正骨,2023,35(10):21.
　YE Ziyang,YE Xiuyun,HU Ting.Analysis of anatomic factors influencing anterior cruciate ligament rupture combined with meniscus tears[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2023,35(11):21.

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更新日期/Last Update: 1900-01-01