B超引导下隐神经射频热凝术治疗膝骨关节炎的疗效观察

Therapeutic effect of radiofrequency thermocoagulation of saphenous nerve guided by B-ultrasound on intractable anterior and medial pain of knee joint

摘要:

目的：观察B超引导下隐神经射频热凝治疗膝关节顽固性前、内侧痛的疗效。方法： 60 例以膝关节前、内侧痛为主的膝骨关节炎患者，按随机数字表分为观察组和对照组，观察组（O组）：B超引导下隐神经射频热凝组 , 行B超引导下隐神经射频热凝加关节腔内玻璃酸钠注射；对照组（C组）：即神经阻滞组，行膝周神经痛点神经阻滞加关节腔内玻璃酸钠注射。分别于治疗前、治疗后 1 周、治疗后 6 周、治疗后 3 月和治疗后 6 月 , 记录骨关节炎指数(western ontario and mcMaster universities osteoarthritis index, WOMAC) 、视觉模拟评分 (visual analogue scale, VAS)和不良反应。结果：两组病人术后 1 周骨关节炎指数和VAS评分均降低，6 周及以后 R 组骨关节炎指数和VAS评分显著低于 C 组 (P < 0.01)。两组病人均未发生明显的不良反应。结论：B超引导下隐神经射频热凝术定位准确，能有效缓解膝骨关节炎膝关节前、内侧痛，可成为治疗膝骨关节炎的新方法。

Abstract:

Objective: to observe the therapeutic effect of radiofrequency thermocoagulation of saphenous nerve under B-ultrasound guidance in the treatment of intractable medial knee pain. Methods: sixty cases of knee osteoarthritis with anterior and medial knee pain were randomly divided into two groups: Observation group(group O) and Control group (group C). group O received radiofrequency thermocoagulation of saphenous nerve guided by B-ultrasound. group C received nerve block of perigenu neuralgia. Both groups received intra articular injection of sodium hyaluronate. Osteoarthritis index (western ontario and mcMaster universities osteoarthritis index, WOMAC) ,and visual analogue score ( VAS) were recorded before treatment, and 1 week, 6 weeks, 3 months and 6 months after treatment to evaluate the therapeutic effect and adverse effects. Results:The WOMAC and VAS were decreased in both groups at 1 week after treatment. Compared with the group C, knee pain decreased more significantly in group R at 1 week after treatment, The WOMAC and VAS in group O were significantly lower than those in group C after 6 weeks. No serious adverse effect appeared in this study. Conclusion: Radiofrequency the rmocoagulation of saphenous nerve guided by B-ultrasound is accurate and can effectively relieve anterior and medial pain in knee osteoarthritis, It may be a new method for the treatment of knee osteoarthritis.