膝骨关节炎单髁置换术联合关节腔内注射倍他米松的临床研究

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摘要目的探讨膝关节单髁置换术(unicompartmental knee arthroplasty，UKA)联合术中关节腔内注射倍他米松对膝关节内侧骨关节炎的疗效。方法选取徐州医科大学附属医院骨科2021年2月至2022年2月治疗的膝关节内侧骨关节炎患者98例，均接受UKA手术，其中男53例，女45例；年龄51~81岁，平均(65.5±7.1)岁。98例患者按使用倍他米松情况分为倍他米松组和非倍他米松组(对照组)，两组患者在性别、年龄、身体质量指数(body mass index，BMI)、术前休息时疼痛视觉模拟评分(visual analogue scale，VAS)、术前活动时VAS评分方面比较，差异无统计学意义(P＞0.05)。采用VAS评分评估术后休息时和活动时患者的疼痛程度。通过测量膝关节周径来评估术后膝关节的肿胀程度。检测术后白细胞计数、C反应蛋白和血沉等实验室数据评估患者术后的局部炎症反应。同时记录阿片类药物的使用量、膝关节的活动范围和术后并发症发生情况。结果两组患者均随访3个月以上。倍他米松组术后1 d、2 d静息状态时膝关节VAS评分较对照组显著降低(P＜0.001)；术后1 d、2 d、4 d活动时的VAS评分较对照组降低(P＜0.05)；术后2 d、4 d、6 d膝关节肿胀程度小于对照组(P＜0.05)；术后1 d、3 d血沉水平低于对照组(P＜0.05)；术后1 d、3 d、6 d C反应蛋白水平低于对照组(P＜0.05)；术后2~4 d阿片类药物用量低于对照组(P＜0.05)。两组患者术后并发症发生率及膝关节活动范围比较，差异无统计学意义(P＞0.05)。结论 UKA联合术中关节腔内注射倍他米松是缓解膝关节骨关节炎患者术后疼痛和炎症的有效方法。类固醇药物的镇痛和抗炎作用可能会减少阿片类药物的消耗，促进早期活动，以提高患者对UKA手术的满意度。

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	史思峰
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关键词 ：膝关节骨关节炎, 单髁置换术, 皮质类固醇, 倍他米松

作者简介: 史思峰(1983－ )，男，副主任医师，徐州医科大学附属医院骨科，467434832@qq.com

引用本文:

史思峰，林强，卢文海. 膝骨关节炎单髁置换术联合关节腔内注射倍他米松的临床研究[J]. 实用骨科杂志, 2023, 29(10): 898-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2023/V29/I10/898

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