脉冲射频术治疗膝骨关节炎的长期疗效研究

Investigation the long-term efficacy of pulsed radiofrequency in treatment of knee osteoarthritis

摘要:

目的：观察脉冲射频术治疗膝骨关节炎的长期临床疗效。方法：前瞻性收集2016年6月至2017年12月解放军总医院第四医学中心骨科收治的符合纳入及排除标准的膝骨关节炎患者120例,随机分为试验组(予以脉冲射频术治疗,n=60)和对照组(予以口服塞来昔布胶囊6周治疗,n=60)。分别于治疗前、治疗后3个月、12个月随访并比较两组患者在视觉模拟评分(visual analogue scale,VAS)和膝关节损伤及骨关节炎调查问卷(Knee injury and Osteoarthritis Outcome Score,KOOS)方面的差异。结果：最终试验组患者57例(95%),对照组患者56例(93.3%)完成随访。两组患者治疗前VAS分值(P=0.57)和KOOS分值(P =0.90)均无显著性差异。治疗后,两组VAS分值均低于治疗前(P＜0.05),KOOS分值均高于治疗前(P=0.000),差异有统计学意义。组间比较疼痛方面,试验组治疗后3个月(t = -4.95,P=0.00)、12个月(t = -5.7,P=0.00)VAS分值均低于对照组,差异有统计学意义；治疗效果方面,试验组治疗后3个月(t = 8.30,P=0.00)和12个月(t = 12.36,P=0.00)KOOS分值均低于对照组,差异有统计学意义。结论：脉冲射频术治疗膝骨关节炎长期效果优于口服塞来昔布,可以显著减轻患者疼痛,改善膝关节功能。

Abstract:

Objective To investigate the long-term clinical efficacy of pulsed radiofrequency in patients with knee osteoarthritis. Methods We enrolled 120 patients with knee osteoarthritis. The patients were randomly allocated into an experimental group (n=60) and a control group (n=60). Patients in the experimental group underwent pulsed radiofrequency therapy for one time. Patients in the control group were treated with celecoxib for six weeks. The patients were evaluated at pre-treatment and 3 and 12 months’ follow-up using visual analog scale (VAS) and Knee injury and Osteoarthritis Outcome Score (KOOS). Results A total of 113 patients(57 in experimental group, 56 in control group) completed the trial. At the baseline, there was no difference of VAS and WOMAC in two groups. The VAS and KOOS scales in both grou reduced significantly at 3 and 12 months follow up compared pretreatment,respectively. Further more, the patients in experimental group improved much better at 3 and 12 months follow up compared with the patients in control group. Conclusions Pulsed radiofrequency was efficacious in treating knee osteoarthritis and can obtain better clinical outcomes than celecoxib.