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[1]鄧偉哲,王宏晶,王宇恒,等.微創(chuàng)針刀鏡治療難治性膝關(guān)節(jié)類風濕關(guān)節(jié)炎[J].中醫(yī)正骨,2015,27(11):42-44.
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微創(chuàng)針刀鏡治療難治性膝關(guān)節(jié)類風濕關(guān)節(jié)炎()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第27卷
期數(shù):
2015年11期
頁碼:
42-44
欄目:
臨床報道
出版日期:
2015-11-30

文章信息/Info

作者:
鄧偉哲1王宏晶2王宇恒1王宇光1張筠1姜宜惠1李春雷1魏博1劉曉萌1秦玉雪2
1.中國人民解放軍第二一一醫(yī)院,黑龍江 哈爾濱 150080;
2.黑龍江中醫(yī)藥大學,黑龍江 哈爾濱 150040
關(guān)鍵詞:
關(guān)節(jié)炎類風濕 膝關(guān)節(jié) 外科手術(shù)微創(chuàng)性 針刀鏡
摘要:
目的:觀察微創(chuàng)針刀鏡治療難治性膝關(guān)節(jié)類風濕關(guān)節(jié)炎的臨床療效和安全性。方法:2014年1—12月,采用微創(chuàng)針刀鏡治療難治性膝關(guān)節(jié)類風濕關(guān)節(jié)炎患者20例,男1例、女19例。年齡27~74歲,中位數(shù)49.5歲。所有患者左膝關(guān)節(jié)癥狀較顯著。術(shù)后隨訪觀察病情改善、并發(fā)癥發(fā)生及患肢功能恢復情況。結(jié)果:手術(shù)時間20~50 min,中位數(shù)30 min。術(shù)后4周,患者對疾病自我評分、醫(yī)生對疾病評分、患者對疼痛評分、健康調(diào)查問卷評分均低于術(shù)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]; 晨僵時間短于術(shù)前[(21.65±3.45)min,(51.15±12.15)min,t=5.054,P=0.001]; 關(guān)節(jié)壓痛數(shù)與關(guān)節(jié)腫脹數(shù)少于術(shù)前[(10.15±2.58)個,(18.90±4.36)個,t=7.719,P=0.014;(9.90±1.65)個,(18.05±2.41)個,t=12.453,P=0.037]; 血清C反應蛋白及血沉水平低于術(shù)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]。均未出現(xiàn)感染等并發(fā)癥。參照美國風濕病學會(American college of rheumatology,ACR)制定的療效評價標準ACR20、ACR50、ACR70評價療效,臨床緩解2例、顯效14例、有效4例。結(jié)論:采用微創(chuàng)針刀鏡治療難治性膝關(guān)節(jié)類風濕關(guān)節(jié)炎,創(chuàng)傷小,能夠緩解膝關(guān)節(jié)疼痛和腫脹,減輕膝關(guān)節(jié)炎癥,有利于恢復患肢功能,提高患者生活質(zhì)量,并發(fā)癥少,值得臨床推廣應用。

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備注/Memo

備注/Memo:
2015-07-03收稿 2015-09-02修回
通訊作者:鄧偉哲 E-mail:[email protected]
更新日期/Last Update: 2015-11-30