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贺涓涓,卫小梅,窦祖林,麦艺颖,岳博宇,解东风,李 娜,姜 丽.超声影像引导髌上囊注射复方倍他米松联合玻璃酸钠治疗膝关节骨性关节炎的回顾性研究[J].中国康复医学杂志,2019,(1):43~47
超声影像引导髌上囊注射复方倍他米松联合玻璃酸钠治疗膝关节骨性关节炎的回顾性研究    点此下载全文
贺涓涓  卫小梅  窦祖林  麦艺颖  岳博宇  解东风  李 娜  姜 丽
中山大学附属第三医院,广州,510630
基金项目:国家自然科学基金项目资助(81201508);广东省自然科学基金项目资助(2015A030313158)
DOI:
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摘要:
      摘要 目的:探讨超声影像引导髌上囊注射复方倍他米松联合玻璃酸钠治疗膝关节骨性关节炎的临床疗效及注射准确率。 方法:对2017年1月—7月我科门诊就诊的膝关节骨性关节炎患者予超声影像引导下髌上囊注射复方倍他米松(1mg,单次注射)联合玻璃酸钠(2.5ml,每周1次、连续注射5周)治疗,分别在患者注射前和注射后采用疼痛视觉模拟量表(VAS)、西部安大略省和加拿大麦克马斯特大学骨关节炎指数(WOMAC)和Lysholm评分对膝痛程度和运动功能进行比较,并对超声影像引导髌上囊注射的准确率及可能的不良反应进行观察。 结果:超声影像引导下髌上囊注射治疗患膝41例,注射准确率为100%。与注射前相比,注射后1周患者VAS评分即显著下降(P<0.0083),1个月后VAS评分继续下降(P<0.0083),注射后3个月VAS评分仍低于注射前(P<0.0083);注射后1个月患者WOMAC评分(P<0.0167)显著下降,Lysholm评分(P<0.0167)显著上升;随访至注射后3个月,WOMAC评分和Lysholm评分与注射前相比仍有显著性差异(P<0.0167);无1例患者发生不良反应。 结论:对于膝关节骨性关节炎的注射治疗,复方倍他米松联合玻璃酸钠治疗能有效缓解膝痛并改善膝关节运动功能;采用超声影像引导髌上囊注射方式有助于精准定位,减少徒手注射带来的不必要损伤,无明显不良反应。
关键词:  骨性关节炎  超声影像  注射
A retrospective study on ultrasound-guided suprapatellar bursal injection of compound betamethasone with sodium hyaluronate in treatment for knee osteoarthritis    Download Fulltext
Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, 510630
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Abstract:
      Abstract Objective: To explore the effect of ultrasound-guided suprapatellar bursal injection of compound betamethasone with sodium hyaluronate in treatment for knee osteoarthritis and accuracy rate of injection. Method: From January 2017 to July 2017,outpatients with knee osteoarthritis in our department were treated with ultrasound-guided suprapatellar bursal injection of compound betamethasone(1mg, single injection) with sodium hyaluronate(2.5ml, weekly injection, for 5 consecutive weeks). Visual analogue scale (VAS), The Western Ontario and McMaster University composite index (WOMCA) and Lysholm score were used to compare knee pain and motor function of patients before and after injection. Accuracy rate of ultrasound-guided suprapatellar bursal injection was analyzed and any possible adverse reactions were recorded. Result: Forty-one affected knees were treated with ultrasound-guided suprapatellar bursal injection and accuracy rate of injection was 100%. Compared with VAS score before injection, it deceased significantly 1 week after injection (P<0.0083), and continued to fall at 1 month after injection (P<0.0083); 3 months after injection, VAS score was still lower than that before injection (P<0.0083). In addition, WOMAC score decreased significantly and Lysholm score increased significantly at 1 month after injection (P<0.0167); follow up to 3 months after injection, the differences were still statistically significant compared with that before injection (P<0.0167). No adverse reaction was observed in any patient. Conclusion: Compound betamethasone with sodium hyaluronate in treatment for knee osteoarthritis can alleviate knee pain and improve motor function remarkably. Ultrasound-guided suprapatellar bursal injection help to locate accurately, reduce possible damages caused by blind injection and has no adverse reaction.
Keywords:knee  osteoarthritis  ultrasonography  injection
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