超声引导下20%葡萄糖髌上囊注射治疗膝骨性关节炎

Ultrasound-guided injection of 20% glucose into the suprapatellar bursa for the treatment of knee osteoarthritis

摘要:

目的：比较髌上囊注射20%葡萄糖注射液和玻璃酸钠注射液治疗膝关节骨性关节炎的短期和长期临床效果。 方法：选取自2021 年2月至 2021年8月符合纳入标准的，在南京医科大学附属江宁医院康复医学中心就诊治疗的60名膝骨关节炎患者，随机分为20%葡萄糖注射组（A组）和玻璃酸钠注射组（B组），A组在超声引导下向髌上囊注射20%葡萄糖10ml，每周注射1次，共3次。B组在超声引导下向髌上囊注射玻璃酸钠注射液2.5ml，每周注射1次，共3次。观察两组治疗前、治疗后1月、3月、6月VAS评分、WOMAC评分变化。 结果：两组在治疗后1、3、6月的VAS评分、WOMAC评分均较治疗前下降(P＜0.05)，差异有统计学意义。治疗6个月后，两组患者的膝关节功能均有显著提高，并且改善的趋势持续至访视结束，但A组似乎更有效。两组患者治疗及随访过程中均未出现不良反应。 结论：通过超声引导下的每周一次（共三次）的髌上囊注射20%葡萄糖，在第6个月时与基线相比，可显著改善KOA患者的疼痛，提高膝关节功能，可以作为临床治疗膝骨性关节炎的一种安全、有效的手段。

Abstract:

Objective Comparison of short-term and long-term clinical effects of suprapatellar bursa injection of 20% glucose injection and sodium hyaluronate injection in the treatment of knee osteoarthritis Methods A total of 60 knee osteoarthritis patients who met the inclusion criteria and were treated in Jiangning Hospital Affiliated to Nanjing Medical University from February 2021 to August 2021 were selected and randomly divided into 20% glucose injection group (group A) and hyaluronic acid Sodium injection group (group B),In group A, 10 ml of 20% glucose was injected into the suprapatellar capsule under the guidance of ultrasound, once a week for a total of 3 times. In group B, 2.5 ml of sodium hyaluronate was injected into the suprapatellar capsule under the guidance of ultrasound, once a week for a total of 3 times.The changes of VAS score, WOMAC index and HSS were observed before treatment, 1 month, 6 months, and 12 months after treatment in the two groups. Results The VAS score, WOMAC index, and HSS score of the two groups at 1, 6, and 12 months after treatment were all lower than those before treatment (P<0.05), and the difference was statistically significant.After 6 months of treatment, both groups improved the level of knee joint function, but group A appeared to be more effective.There were no adverse reactions in the two groups of patients during treatment and follow-up. Conclusions Ultrasound-guided weekly (three times) injection of 20% dextrose into the suprapatellar capsule can significantly improve pain and knee function in KOA patients compared with baseline at 6 months, which can be used as a clinical treatment for knee A safe and effective treatment for osteoarthritis.