丰凡翔,沈海,李游,等.超声引导下膝周神经阻滞治疗膝骨性关节炎的疗效观察[J].中华物理医学与康复杂志,2025,47(9):834-840
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| 超声引导下膝周神经阻滞治疗膝骨性关节炎的疗效观察 |
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| DOI：10.3760/cma.j.cn421666-20250113-00038 |
| 中文关键词: 超声引导 神经阻滞 膝骨性关节炎 |
| 英文关键词: Ultrasound guidance Nerve block Knee osteoarthritis |
| 基金项目:重庆市科卫联合医学科研项目（2022ZDXM038）；四川省中医药管理局科学技术研究专项课题（2020LC0185） |
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| 中文摘要: |
| 目的 观察超声引导下膝周神经阻滞治疗膝骨性关节炎（KOA）的疗效。 方法 采用随机数字表法将符合纳入标准的102例KOA患者分为对照组和观察组，每组51例。研究期间，2组均有5例患者脱落，最终对照组和观察组分别纳入46例患者。2组患者均给予口服药物、针刺、运动训练、物理因子治疗及手法推拿治疗，连续2周；观察组在此基础上予以超声引导下的膝周神经阻滞治疗，每周1次，连续2周。治疗前、治疗2周及8周后，采用视觉模拟评分法（VAS）、西安大略和麦克马斯特大学（WOMAC）骨关节炎指数及6分钟步行测试（6MWT）对2组患者的疗效进行评定。 结果 观察组治疗2周及8周后的膝关节疼痛VAS评分、WOMAC骨关节炎指数子项及总分均较组内治疗前显著改善（P＜0.05），而对照组仅治疗2周后的上述指标较组内治疗前改善（P＜0.05）。与对照组同时间点比较，观察组治疗2周后［(3.54±2.00)分］及8周后［(4.13±2.04)分］的膝关节疼痛VAS评分、治疗8周后的WOMAC骨关节炎指数子项评分及总分［(36.91±16.91)分］改善较为优异（P＜0.05）。观察组治疗2周后［(434.22±125.19)m］及8周后［(446.35±126.45)m］的6MWT距离较组内治疗前和对照组改善优异（P＜0.05）。 结论 超声引导下的膝周神经阻滞能快速、精准、有效、持久地缓解KOA患者的疼痛症状，改善膝关节功能，提高步行耐力。 |
| 英文摘要: |
| Objective To document the effectiveness of ultrasound-guided genicular nerve block (GNB) in treating knee osteoarthritis (KOA). Methods A total of 92 KOA patients were randomly divided into an observation group and a control group with 46 in each. Those in both groups were treated conventionally, including with non-steroidal anti-inflammatory drugs, acupuncture, ultrasound, laser irradiation and manipulation therapy. The observation group additionally underwent ultrasound-guided genicular nerve block treatment, once a week for 2 weeks. Pain scoring on a visual analog scale (VAS), the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and a 6-minute walk test (6MWT) were used to evaluate everyone before and after the treatment, and then 8 weeks later. Results In the observation group the average VAS rating ［(3.54±2.00) at week 2 and (4.13±2.04) at week 8］ and the average WOMAC subscale and total scores ［(36.91±16.91) at week 8］ had improved significantly right after the experiment and 8 weeks later. But in the control group this was true only right after the treatment. The observation group also demonstrated superior improvements in 6MWT distance at week 2 ［(434.22±125.19)m］ and week 8 ［(446.35±126.45)m］ compared to both its own baseline and the control group. Conclusions Ultrasound-guided genicular nerve block is a rapid, precise, effective, and long-lasting intervention for alleviating pain, improving knee function and enhancing walking endurance in KOA patients. |
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