骨关节军事训练伤临床病理研究  

Clinicopathological features of military training injury of the joints

作　　者：马小梅 邹薇薇 符培亮 祝峙 MA Xiao-mei;ZOU Wei-wei;FU Pei-liang;ZHU Zhi(Department of Pathology,Changzheng Hospital Affiliated to Naval Military Medical University,Shanghai 200003,China;Department of Pathology Imaging,Changzheng Hospital Affiliated to Naval Military Medical University,Shanghai 200003,China;Department of Orthopaedics,Changzheng Hospital Affiliated to Naval Military Medical University,Shanghai 200003,China)

机构地区：[1]海军军医大学第二附属医院病理科,上海200003 [2]海军军医大学第二附属医院影像科,上海200003 [3]海军军医大学第二附属医院骨科,上海200003

出　　处：《诊断病理学杂志》2023年第10期952-955,981,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨骨关节军事训练伤临床病理特点。方法回顾性分析军事训练致骨关节损伤需手术治疗,且手术中需要切除组织行病理诊断患者的临床病理情况。结果37例有病理诊断的军事训练伤致四肢大关节患者,均为男性,平均年龄28.37岁(19~47岁),武警23例,陆军8例,海军4例,空军2例;战士25例,干部12例,下肢关节22例,其中膝关节10例(13个关节),踝关节6例(7个关节),髋关节6例;上肢关节6例,其中肩关节3例,腕关节2例,肘关节1例;右侧关节12例,左侧关节13例,左右侧关节3例;脊柱椎间盘9例(12个椎间隙);患者手术前病史3天至8年不等,四肢平均2.12年,脊柱椎间盘突出症平均2.55个月;四肢大关节病理变化包括慢性滑膜炎6例,急慢性滑膜炎2例,13例滑膜未见炎细胞浸润,关节囊肿4例,股骨头坏死3例,钙化变性2例,骨折后病理愈合2例,肿瘤及瘤样病变2例。椎间盘突出症病理变化主要为纤维软骨变性9例,肉芽组织增生2例。结论军事训练伤以四肢大关节最常见,病理变化以滑膜炎症和变性多见,同时也要高度警惕罕见的创伤后瘤样病变和肿瘤,避免误诊误治。Objective To investigate the clinicopathological characteristics of bone and joint military training injuries.Methods The clinical and pathological conditions of patients with bone and joint injuries caused by military training who needed surgical treatment and pathological diagnosis during operation were analyzed retrospectively.Results Thirty-seven patients with major joint of limbs caused by military training with pathological diagnosis were all male,with an average age of 28.37 years(19-47 years),including 23 armed police,8 army,4 navy and 2 air force.There were 25 soldiers,12 officers and 22 lower limb joints,including 10 knee joints(13 joints),6 ankle joints(7 joints)and 6 hip joints.There were 6 upper limb joints,including 3 shoulder joints,2 wrist joints and 1 elbow joint.There were 12 cases of right joint,13 cases of left joint and 3 cases of left and right joint.9 cases of intervertebral disc(12 intervertebral spaces);The patient’s preoperative medical history ranged from 3 days to 8 years,with an average of 2.12 years in limbs and 2.55 months in spinal disc herniation.Pathological changes of joints of limbs included chronic synovitis in 6 cases,acute and chronic synovitis in 2 cases,no inflammatory cell infiltration in synovium in 13 cases,joint cyst in 4 cases,femoral head necrosis in 3 cases,calcified degeneration in 2 cases,pathological healing after fracture in 2 cases,and tumor and tumor-like lesions in 2 cases.The pathological changes of disc herniation were mainly fibrocartilage degeneration in 9 cases and granulation tissue hyperplasia in 2 cases.Conclusion Military training injuries are most common in the joints of limbs,and synovitis and degeneration are the most common pathological changes.At the same time,we should be highly alert to rare post-traumatic tumor-like lesions and tumors,to avoid misdiagnosis and mistreatment.

关 键 词：军事训练 病理 关节 滑膜病变 缺血性筋膜炎 腱鞘巨细胞瘤 

分 类 号：R826.6[医药卫生—临床医学]