摘要目的 观察关节镜下清理术治疗大骨节病踝关节的临床治疗效果.方法 采用前瞻性设计方法,选择2015年1月至2016年10月在大庆市第五医院进行关节镜下清理术治疗的大骨节病踝关节病变患者,于治疗前,治疗后6、12个月时,采用视觉模拟评分法评价疼痛情况,踝-足评分系统及踝关节背伸活动度评分评价行走功能,并以问卷调查形式调查患者生活质量.结果 共调查40例患者,于治疗前,治疗后6、12个月,患者视觉模拟评分分别为(6.2±1.0)、(2.3±1.2)、(1.6±0.4)分;踝-足评分分别为(53.3±6.8)、(86.6±5.1)、(88.7±6.2)分;踝关节背伸活动度评分分别为(15.9±4.1)、(36.9±4.9)、(41.8±6.4)分;生活质量评分分别为(53.1±4.0)、(75.4±6.6)、(88.7±10.5)分,组间比较差异有统计学意义(F=2.1、2.6、2.3、2.5,P均＜0.05).其中,治疗后6、12个月的视觉模拟评分明显低于治疗前,踝-足评分、踝关节背伸活动度评分及生活质量评分明显高于治疗前(P均＜ 0.05).结论 利用关节镜下清理术治疗大骨节病踝关节病变患者,能够有效缓解患者的疼痛,明显改善患者行走功能,显著提高患者的生活质量,值得在临床治疗中广泛推广.

abstractsObjective To analyze the clinical effect of debridement in the treatment of Kashin-Beck disease under an ankle arthroscopy.Methods Totally 40 patients with ankle Kashin-Beck disease who had underwent surgery in the Fifth Hospital of Daqing from January 2015 to October 2016 were selected as the research subjects.All patients were treated with cleaning treatment under arthroscopy,evaluated via the visual analogue scale method,and compared pain before and 6,12 month after the treatment.Walking function and ankle motion of the patients were evaluated via an ankle-scoring system,and the quality of life of patients was investigated before and after the treatment through a questionnaire survey.Results The visual analogue scale of before and 6,12 months after the treatment was (6.2 ± 1.0),(2.3 ± 1.2) and (1.6 ± 0.4) scores,respectively;ankle foot score (53.3 ± 6.8),(86.6 ± 5.1) and (88.7 ± 6.2) scores,respectively;ankle activity score (15.9 ± 4.1),(36.9 ± 4.9) and (41.8 ± 6.4) scores,respectively;and life quality score (53.1 ± 4.0),(75.4 ± 6.6) and (88.7 ± 10.5) scores,respectively.The differences between groups were statistically significant (F =2.1,2.6,2.3,2.5,P ＜ 0.05).Visual analogue scale of 6 and 12 months after the treatment was significantly lower than that before the treatment,ankle foot score and ankle activity score and life quality score were significantly higher than those before the treatment (P ＜ 0.05).Conclusion The debridement under an ankle arthroscopy can effectively reduce the pain of patients with Kashin-Beck disease,and improve the walking function of the patients obviously,significantly improve the patients' life quality,and the method should be widely applied in clinical treatment.