探讨全膝关节置换术在类风湿关节炎患者中的应用效果。

选取2017年1月至2019年3月广西壮族自治区桂东人民医院收治的79例类风湿关节炎患者作为研究对象，采用随机数字表法分为研究组(n＝40)及对照组(n＝39)。对照组给予硫酸羟氯喹片进行治疗，研究组在对照组的基础上给予全膝关节置换术进行治疗，两组均治疗4周。使用t检验分析并比较两组治疗前、治疗4周后的膝关节功能、生活质量、血清细胞因子水平，并予以卡方检验比较两组治疗期间的并发症发生率及研究组治疗4周后的膝关节冠状面与矢状面畸形率。

与治疗前相比，治疗4周后，两组美国特种外科医院(HSS)评分、关节活动度及生活质量各维度评分均升高，研究组高于对照组(t＝7.222、2.226、16.611、13.035、14.563、4.344，均为P<0.05)；而两组血清类风湿因子(RF)、C-反应蛋白(CRP)、血沉(ESR)水平均降低，研究组低于对照组(t＝33.330、3.578、2.819，均为P<0.05)。治疗4周后，研究组膝关节冠状面与矢状面畸形率均低于治疗前(22.5% vs 52.5%，20.0% vs 50.0%；χ²＝7.680、7.912，均为P<0.05)。两组治疗期间的并发症发生率比较差异无统计学意义(5.00% vs 10.26%，χ²＝0.777，P>0.05)。

全膝关节置换术治疗类风湿关节炎，可显著降低患者血清RF、CRP、ESR水平，提高患者HSS评分及关节活动度，继而可促进患者膝关节功能的恢复，提高其生活质量，且高安全性好。

To investigate the effect of total knee arthroplasty in the patients with rheumatoid arthritis.

A total of 79 patients with rheumatoid arthritis treated in Guidong People's Hospital of Guangxi Zhuang Autonomous Regionl between January 2017 and March 2019 were selectedas the research objects, and they were divided into the study group (n=40) and the control group (n=39) using a random number table method. The control group were treated with hydroxychloroquine sulfate tablets, and the study group were treated with total knee arthroplasty on the basis of the control group. Both the two groups were treated for four weeks. The knee joint function, quality of life, the levels of serum cytokine before and after four weeks of treatment were analyzed and compared by t test, the incidence of complications during treatment and the study group coronal and sagittal deformities of the posterior knee after treatment in the two groups were analyed and compared by chi-square test.

Compared with before treatment, after four weeks of treatment, the score of american hospital for special surgery (HSS), joint mobility and the score of various dimensions of quality of life of the two groups increased, the study group was higher than the control group (t=7.222, 2.226, 16.611, 13.035, 14.563, 4.344, all P<0.05); while the levels of serum rheumatoid factor (RF), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) of the two groups decreased, the study group was lower than the control group (t=33.330, 3.578, 2.819, all P<0.05). After four weeks of treatment, the rates of coronal and sagittal deformities of the knee joint in the study group were lower than before treatment (22.5% vs 52.5%, 20.0% vs 50.0%; χ²=7.680, 7.912, P<0.05). The incidence of complications between the two groups during treatment showed no statistically significant difference (5.0% vs 10.3%, χ²=0.777, P>0.05).

Total knee arthroplasty for rheumatoid arthritis could significantly reduce the levels of serum RF, CRP, and ESR in patients, and could increase the scores of HSS in patientsand joint mobility, thereby promoting the recovery of knee function and improving the quality of life of patients, and with high security.