中国组织工程研究

中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (31): 5068-5074.doi: 10.3969/j.issn.2095-4344.2014.31.025

• 骨与关节综述 bone and joint review • 上一篇    下一篇

骨科临床中的关节腔内用药：特点与价值

马金辉1，孙  伟2，高福强2，王云亭2，李子荣2   

  1. 北京大学中日友好医院，1骨科，2骨关节外科，骨坏死与关节保留重建中心，北京市  100029
  • 收稿日期:2014-05-07 出版日期:2014-07-23 发布日期:2014-07-23
  • 通讯作者: 孙伟，主任医师，副教授，硕士生导师，北京大学中日友好医院骨关节外科，骨坏死与关节保留重建中心，北京市 100029
  • 作者简介:马金辉，男，1988年生，辽宁省鞍山市人，汉族，北京大学医学部中日友好临床医学院在读硕士，主要从事股骨头坏死、关节置换方面的研究。
  • 基金资助:

    国家自然科学基金面上项目(81372013)；中日友好医院面上项目(2013-MS-27)

Clinical application of intra-articular injection drugs in orthopedics: features and value

Ma Jin-hui1, Sun Wei2, Gao Fu-qiang2, Wang Yun-ting2, Li Zi-rong2   

  1. 1Department of Orthopedics, 2Department of Orthopedic Surgery, Osteonecrosis and Joint Reservation Reconstruction Center, China-Japan Friendship Hospital, Peking University, Beijing 100029, China
  • Received:2014-05-07 Online:2014-07-23 Published:2014-07-23
  • Contact: Sun Wei, Chief physician, Associate professor, Master’s supervisor, Department of Orthopedic Surgery, Osteonecrosis and Joint Reservation Reconstruction Center, China-Japan Friendship Hospital, Peking University, Beijing 100029, China
  • About author:Ma Jin-hui, Studying for master’s degree, Department of Orthopedics, China-Japan Friendship Hospital, Peking University, Beijing 100029, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81372013; the General Project of China-Japan Friendship Hospital, No. 2013-MS-27

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摘要：

背景：关节腔内用药作为骨科领域一种较为常见的用药方法，疗效显著，同时存在一定并发症。其在一定程度上迎合了患者对手术恐惧的心理，可以作为一种保守治疗手段，但也有些专家认为由于药物注射时无菌条件限制，关节腔内注射药物会增加关节内感染的概率而持反对意见。
目的：总结近年来通过关节腔内给药方式使用的药物、疗效及其不良反应，并阐明关节腔内给药在骨科相关领域的应用。
方法：应用计算机检索PubMed及万方中文系列数据库检索2007年1月至2013年12月关于关节腔内给药在骨科相关领域临床应用的文章，检索词为“intra-articular，injection，orthopaedics，tranexamic acid，hyaluronic acid，corticosteroid，drugs，关节腔内给药”，对资料进行初审，排除较旧和重复性研究。共搜集到符合纳入标准的文献43篇。
结果与结论：在骨科相关领域中，关节腔内用药操作方法简单，经济，有效，但同时存在一定的不良反应。关节腔内注射止血剂氨甲环酸可以明显减少关节置换后患者的失血量并且经济、安全；关节腔内注射关节润滑剂能够减少关节内摩擦，改善关节腔内粘连，可以作为治疗骨关节炎的一种较好的保守方法。而关节腔内注射激素类药物可以治疗炎性关节炎，短期疗效明显，但由于长期应用的不良反应较大，现已不推荐使用。关节腔内注射镇痛药物及其他药物利弊并存。总之，关节腔内用药疗效显著，但仍存在一定的并发症，骨科医生应掌握好适应证，合理应用相关药物，且仍需进一步大规模研究，制定出疗效确切、不良反应小的关节腔内用药方案。


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

关键词: 植入物, 关节植入物, 关节腔, 关节置换, 用药, 骨关节炎, 氨甲环酸, 透明质酸, 效果, 国家自然科学基金

Abstract:

BACKGROUND: As a more common method in the orthopedic field, the method of intra-articular injection drugs has distinct curative effects, but there are some complications. In a certain extent, this method caters to the psychological fear of surgery, and can serve as a kind of conservative treatment. But some experts believed that because of the limit of sterile conditions, intra-articular injection of drugs will increase the risk of intra-articular infection and they opposed this method.  OBJECTIVE: To review the efficacy and adverse reactions of intra-articular injection drugs in recent years, and explain clinical applications of intra-articular injection drugs in orthopedics.
METHODS: A computer-based search was conducted in PubMed and Wanfang database for articles related to the application of intra-articular injection drugs in orthopedics published between January 2007 and December 2013. The English and Chinese key words were “intra-articular, injection, orthopaedics, tranexamic acid, hyaluronic acid, corticosteroid, drugs”. Data were checked in the first trial, old articles and repetitive studies were excluded. The relevant 43 articles accorded with inclusion criteria were reviewed.
RESULTS AND CONCLUSION: In orthopedics, the method of intra-articular injection drugs is simple, economic and effective, but at the same time, there are some side effects. Tranexamic acid by intra-articular injection can significantly reduce blood loss after total joint replacement, is safety and economic. Intra-articular injection joint lubricant can reduce internal friction of joints and improve the adhesion of joint cavity, can be used as a good conservative treatment for osteoarthritis. Intra-articular injection hormone drugs can treat inflammatory arthritis, and short-term curative effect is obvious, but due to large long-term side effects, the method is not recommended now. Intra-articular injection of analgesic drugs and other drugs have both advantages complications. The efficacy of intra-articular injection drugs in orthopedics is obvious; meanwhile, this method has some complications. Orthopedic surgeons should select related drugs by indications. We still need to further make reasonable regimen with intra-articular injection drugs in future large-scale study.


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：


中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程


全文链接：

Key words: arthroplasty, replacement, osteoarthritis, hormones, tranexamic acid

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