放散式体外冲击波治疗膝骨关节炎伴膝关节周围韧带钙化的疗效观察

Short-term clinical effect of rESWT in treatment of knee osteoarthritis ligament calcification

摘要:

目的 探讨放散式体外冲击波治疗膝骨关节炎伴膝关节周围韧带钙化的临床疗效。方法 选取2018年1月—10月就诊于中国医科大学附属盛京医院的膝骨关节炎伴膝关节周围韧带钙化患者40例，随机分为观察组和对照组，每组20例。观察组患者采取放散式体外冲击波治疗，对照组采取膝关节周围钙化点注射治疗。比较两组患者治疗前、第1次治疗后、第2次治疗后、第3次治疗后、第4次治疗后及治疗结束后4周的视觉模拟评分（VAS）、Lysholm膝关节功能评分，同时应用三维彩超评估膝关节周围韧带的钙化吸收情况，并统计治疗结束4周后的患者满意度。结果 不同时间点VAS评分、两组VAS评分、两组VAS评分变化趋势比较，差异有统计学意义（P <0.05）；与治疗前比较，两组患者治疗后VAS评分下降（P <0.05），第3次治疗后、第4次治疗后及治疗结束后4周，观察组VAS评分下降幅度较对照组大（P <0.05）。不同时间点ysholm膝关节功能评分、两组ysholm膝关节功能评分、两组ysholm膝关节功能评分变化趋势比较，差异有统计学意义（P <0.05）；与治疗前比较，两组治疗后的Lysholm膝关节功能评分升高（P <0.05），且第2次治疗后，观察组Lysholm膝关节功能评分提高程度较对照组更显著（P <0.05）。不同时间点的膝关节周围钙化韧带最大横径、两组膝关节周围钙化韧带最大横径、两组膝关节周围钙化韧带最大横径的变化趋势比较，差异有统计学意义（P <0.05）；治疗前，两组患者膝关节周围钙化韧带最大横径比较，差异无统计学意义（P >0.05），第2次治疗后，观察组患者膝关节周围钙化韧带横径较治疗前缩小（P <0.05），对照组患者膝关节周围钙化韧带横径较治疗前差异无统计学意义（P >0.05）。观察组患者满意度高于对照组（P <0.05）。结论 放散式体外冲击波治疗膝骨关节炎伴膝关节周围韧带钙化具有更好的临床疗效，膝关节功能恢复更快，可促进韧带钙化灶吸收，患者满意度更高，值得推广。

Abstract:

Objective To compare the short-term clinical effect of radiation-type extracorporeal shock wave therapy (rESWT) and perigenicinjection in the treatment of knee osteoarthritis ligament calcification.Method Forty cases of patients with knee osteoarthritis and ligament calcification were randomly divided into the observation group (20 cases) and the control group (20 cases). Patients in the observation group were treated with rESWT, while patients in the control group were treated with perigenicular calcification point injection therapy. The VAS (visual analogue scale) scores, Lysholm knee function scores of two groups before treatment, after the first, the second, the third, the fourth treatment, and 4 weeks after treatment were analyzed. Meanwhile, three-dimensional ultrasonography was used to assess the absorption of calcification, and the patient satisfaction after 4 weeks of treatment was calculated.Result The VAS scores of the two groups before treatment, after the first treatment, after the second treatment, after the third treatment, after the fourth treatment and 4 weeks after treatment, the differences were statistically significant (P < 0.05). Compared with before treatment, the VAS score of the two groups decreased after treatment (P < 0.05). After the third treatment, after the fourth treatment, and 4 weeks after the end of treatment, the VAS score of the observation group decreased more than that of the control group (P < 0.05). The Lysholm knee function scores of the two groups before treatment, after the first treatment, after the second treatment, after the third treatment, after the fourth treatment and 4 weeks after treatment were statistically significant (P < 0.05); Compared with before treatment, Lysholm knee function score of the two groups increased (P < 0.05), and after the second treatment, Lysholm knee function score of the observation group improved more significantly than that of the control group (P < 0.05). Before treatment, after the first treatment, after the second treatment, after the third treatment, after the fourth treatment and 4 weeks after treatment, the maximum transverse diameter of calcified ligaments around the knee joint of the two groups was significantly different (P < 0.05); Before treatment, there was no significant difference in the maximum transverse diameter of calcified ligaments around the knee between the two groups (P > 0.05). After the second treatment, the transverse diameter of calcified ligaments around the knee in the observation group decreased compared with that before treatment (P < 0.05), and there was no significant difference in the transverse diameter of calcified ligaments around the knee in the control group (P > 0.05). The satisfaction of the observation group was higher than that of the control group (P < 0.05).Conclusion rESWT has more obvious and faster clinical efficacy in the treatment of knee osteoarthritis with ligament calcification, promoting the absorption of ligament calcification, with high assessment, which is worthy of promotion.