关节镜下滑膜切除术治疗早、中期类风湿性关节炎的疗效  

Arthroscopic synovectomy for rheumatoid arthritis in early and middle stages

作　　者：张峻[1] 侯筱魁[1] 王友[1] 史定伟[1] 

机构地区：[1]上海市第二医科大学附属第九人民医院骨科,上海200011

出　　处：《中国微创外科杂志》2005年第5期355-357,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨关节镜下滑膜切除术治疗早期和中期类风湿性关节炎(类风关)的疗效。　方法　对34例早中期的类风关42个膝关节(早期类风关组22例, 24个关节;中期类风关组12例, 18个关节),在关节镜下施行以滑膜切除术为主处理,其中32个膝关节辅助使用双极射频进行滑膜的清除和止血。术后给予正规抗类风湿药物治疗,对早、中期两组进行随访(平均25月),包括关节功能的评定,检测血沉(erythrocytesedimentationrate,ESR)、C-反应蛋白(Creactionprotein)和类风湿因子(rheumatoidfactor,RF)。　结果　早期类风关组24个膝关节术后优良率为91 7% (22 /24),中期类风关组18个膝关节优良率为66. 7% (12 /18),二者优良率差异无显著性(χ2 =2 .705,P=0 .100)。　结论　早期和中期类风关关节镜下滑膜切除术治疗,均可以取得较满意的疗效,二者疗效无差别。双极射频有助于彻底清除病变滑膜、减少关节血肿、利于关节功能康复。Objective To compare the efficacy of arthroscopic synovectomy between early and middle stage rheumatoid arthritis. Methods A total of 34 cases of rheumatoid arthritis (42 knee joints) either in early stage (22 cases, 24 joints) or in meddle stage (12 cases, 18 joints) underwent arthroscopic synovectomy. The bipolar radiofrequency was used for the synovial debridement and hemostasis in 32 knee joints. Postoperatively, routine anti-rheumatoid drugs were administrated. Follow-up observations in the two groups included the evaluation of knee function, the erythrocyte sedimentation rate (ESR), the C-reaction protein (CRP), and the rheumatoid factor (RF). Results The rate of excellent or good results was 91.7% in early stage (22/24) and 66.7% in middle stage (12/18), without statistical significance between the two groups ( χ 2=2.705, P =0.100). Conclusions Arthroscopic synovectomy is effective for the treatment of rheumatoid arthritis in both early and middle stage. Bipolar radiofrequency is helpful for the complete elimination of the synovium, the prevention of joint hematoma, and the rehabilitation of joint function.

关 键 词：关节镜 滑膜切除术 类风湿性关节炎 

分 类 号：R687.3[医药卫生—骨科学]