标题：氨甲环酸联合地塞米松关节腔注射对半月板损伤膝关节镜术后功能恢复及预后的影响

      作者：钟裕新 1，伍秀东 2，李文华 2    东莞市长安医院急诊外科 1、骨外科 2，广东 东莞 523000

      卷次： 2022年33卷13期

      【摘要】 目的 探讨氨甲环酸联合地塞米松关节腔注射对半月板损伤膝关节镜术后功能恢复及预后的影响。方法 选择2018年至2021年5月在东莞市长安医院接受膝关节镜手术治疗的52例半月板损伤患者为研究对象，按随机数表法将患者分为观察组和对照组各26例。两组患者均接受膝关节镜手术治疗，对照组患者术中使用地塞米松关节腔注射，观察组患者在对照组治疗的基础上联合注射氨甲环酸。比较两组患者术后1个月的临床疗效，术前、术后1 d、3 d、5 d、7 d时的膝关节周径、视觉模拟评分法(VAS)的变化，以及术前、术后1个月时Lysholm评分、国际膝关节评分委员会(IKDC)膝关节主观功能评分和关节活动度的变化，并记录两组患者治疗期间的不良反应发生情况。结果 术后1个月时，观察组患者的临床疗效优良率为88.46%，明显高于对照组的65.38%，差异有统计学意义(P<0.05)；术后1 d、3 d时，观察组患者膝关节周径分别为(44.02±2.31) cm、(44.57±2.20) cm，明显小于对照组的(46.39±2.72) cm、(46.98±2.65) cm，差异均有统计学意义(P<0.05)；术后1 d、3 d、5 d时，观察组患者的VAS评分分别为(4.62±0.71)分、(3.05±0.40)分、(2.16±0.43)分，明显低于对照组的(5.48±0.55)分、(4.12±0.59)分、(3.07±0.39)分，差异均有统计学意义(P<0.05)；术后1个月时，观察组患者的Lysholm评分、IKDC膝关节主观功能评分、关节活动度分别为(86.92±7.33)分、(80.35±6.40)分、(133.57±7.94)°，明显高于对照组的(80.15±6.14)分、(73.26±5.17)分、(127.62±7.17)°，差异均有统计学意义(P<0.05)；两组患者治疗期间均无明显不良反应，且无下肢深静脉血栓、凝血功能异常等情况发生。结论 氨甲环酸联合地塞米松关节腔注射可有效促进半月板损伤患者膝关节镜术后功能恢复，改善预后，值得临床推广。
      【关键词】 半月板损伤；膝关节镜术；氨甲环酸；地塞米松；膝关节功能；预后
      【中图分类号】 R684 【文献标识码】 A 【文章编号】 1003—6350（2022）13—1686—04

Effect of intra-articular injection of tranexamic acid and dexamethasone on functional recovery and prognosisafter knee joint arthroscopic surgery for meniscus injury.
ZHONG Yu-xin 1, WU Xiu-dong 2, LI Wen-hua 2.Department of Emergency Surgery 1, Department of Orthopedics 2, Dongguan Chang'an Hospital, Dongguan 523000,Guangdong, CHINA
【Abstract】 Objective To study the effect of intra-articular injection of tranexamic acid and dexamethasone onfunctional recovery and prognosis after knee joint arthroscopic surgery for meniscus injury. Methods Fifty-two pa-tients with meniscus injury who underwent knee arthroscopic surgery in Dongguan Chang'an Hospital from 2018 to May2021 were selected and divided into an observation group and a control group according to the random number tablemethod, with 26 patients in each group. Two groups of patients received knee joint arthroscopic surgery. Patients in thecontrol group received intra-articular injection of dexamethasone, and those in the observation group received intra-artic-ular injection of tranexamic acid and dexamethasone. The clinical efficacy at 1 months after operation, the changes ofthe knee circumference, Visual Analogue Scale (VAS) before operation, 1 day, 3 days, 5 days, and 7 days after opera-tion, the Lysholm score, International Knee Rating Committee (IKDC) knee function score, and joint activity before op-eration and at 1 month after operation were compared between the two groups, and the adverse reactions during treat-ment were recorded. Results At 1 month after operation, the excellent and good rate in the observation group was88.46%, which was significantly higher than 65.38% in the control group (P<0.05). At 1 day, 3 days after operation, theknee meridian in the observation group were (44.02±2.31) cm and (44.57±2.20) cm, which were significantly lowerthan (46.39±2.72) cm and (46.98±2.65) cm of control group (P<0.05). At 1 day, 3 days, and 5 days after operation, theVAS scores in the observation group were (4.62±0.71) points, (3.05±0.40) points, and (2.16±0.43) points, which weresignificantly lower than (5.48±0.55) points, (4.12±0.59) points, and (3.07±0.39) points of the control group (P<0.05). At1 month after operation, the Lysholm score, IKDC knee subjective function score, and joint activity in the observationgroup were (86.92±7.33) points, (80.35±6.40) points, (133.57±7.94)° , which were significantly higher than (80.15±6.14) points, (73.26±5.17) points, (127.62±7.17)° of the control group (P<0.05). No obvious adverse reactions occurred