老年人膝关节化脓性关节炎的关节镜下治疗  

The treatment of knee pyogenic arthritis under arthroscopy for the elderly

作　　者：黄建荣[1] 李卫平[1] 沈慧勇[1] 林道贤[1] 宋卫东[1] 刘尚礼[1] 王志勇[1] 马文谱[1] 程志安[1] 

机构地区：[1]中山大学附属第二医院骨科,广州市510120

出　　处：《中华老年医学杂志》2006年第7期531-533,共3页Chinese Journal of Geriatrics

基　　金：广东省自然科学基金资助项目(5300677)

摘　　要：目的评价老年人膝关节化脓性关节炎关节镜治疗效果。方法18例63～83岁的老年化脓性膝关节炎患者,通过关节液检查、皮温及体温变化、关节活动度的改善及Lysholm膝关节功能评分等方面评价治疗效果。结果术后2 d,18例体温均恢复正常;17 d皮温恢复正常。术前Lysholm膝关节功能评分为(41．7±9．5)分,术后12周为(84．6±6．3)分,二者差异有统计学意义(P<0．01)。无并发骨髓炎,无死亡病例。结论关节镜下关节清理术结合关节持续灌洗治疗老年人化脓性关节炎疗效满意,该方案具有清创彻底、创伤小、膝关节功能恢复满意、并发症少等优点。Objective To evaluate the therapeutic effect of knee pyogenic arthritis under arthroscopy for the elderly and analyze the influential factor on the effect retrospectively. Methods Of the 18 cases with knee pyarthrosis, there were 7 cases complicated with diabetes mellitus, 5 cases with osteoarthritis, 2 cases with rheumatoid arthritis and 2 cases with urarthritis. The arthroscopic subtotal synovectomies and debridement were performed in all cases, which was combined with intravenous antibiotics, continuous lavement of joint cavity and rehabilitation postoperatively. The therapeutic effect was evaluated according to the changes of temperature, the properties of joint fluid and Lysholm knee function score. Results The high body temperature returned to normal at an average of 2 days. The temperature of the skin around the knee joint returned to normal at an average of 17 days. The preoperative Lysholm knee function score was （41.7±5.9） in average, and in contrast, the postoperative Lysholm knee function score was （84.6±6.3） in average （P〈0.01）. Conclusions Arthroscopic procedure is a minimal invasive treatment for the purulent knee arthritis, possessing the unique superiorities of thorough debridement, easy control of infection and satisfactory restoration of the knee function.

关 键 词：关节镜 膝关节 关节炎 感染性 

分 类 号：R687.3[医药卫生—骨科学]