关节镜下治疗膝关节弥漫性色素沉着绒毛结节性滑膜炎的疗效分析  

Arthroscopic synovectomy for diffused pigmented villonodular synovitis of the knee

作　　者：顾强荣[1] 王黎明[1] 桂鉴超[1] 宋华荣[1] 黄河[1] 

机构地区：[1]南京医科大学附属南京第一医院骨科,江苏南京210006

出　　处：《医学研究生学报》2009年第8期826-829,共4页Journal of Medical Postgraduates

基　　金：南京市外国专家局基金资助项目(批准号:G20023210048)

摘　　要：目的：膝关节弥漫性色素沉着绒毛结节性滑膜炎（PVNS）常采用开放手术的方法进行治疗,但是开放手术难以彻底切除滑膜,且术后常会造成膝关节的屈伸功能障碍。文中在关节镜下治疗膝关节弥漫性PVNS,探讨其方法和疗效。方法：2004年9月至2007年11月用刨刀联合等离子刀在关节镜下对17例膝关节弥漫性PVNS患者进行滑膜全切。在常规入路基础上,建立跨后纵隔入路对后关节囊的滑膜进行切除,术后随访并用改良的Ogilvie-Harris评分标准评价临床疗效。结果：所有病例随访平均28.4个月（6-45个月）,关节肿痛等自觉症状均未见复发,术前评分平均为2.53分,术后6月平均为12.41分,其中优12例,良3例,中2例,优良率达88.2%。结论：关节镜手术创伤小、恢复快,是目前治疗弥漫性PVNS的首选方法。Objective： Diffused pigmented villonodular synovitis of the knee is usually treated by open operation, but open synovectomy can not resect the synovium completely and may easily cause knee dysfunction. The purpose of this study was to explore the technique and clinical effect of arthroseopic synovectomy in the treatment of diffused pigmented villonodular synovitis. Methods ： Seventeen cases of diffused pigmented villonodular synovitis were treated by arthroscopic synovectomy using the combined method of mechanical gouging with radiofrequency. The trans-posterior-septal approach was introduced to the debridement of the synovium in the posterior chamber. All the patients were followed up for 6 - 45 months, and the results evaluated according to the modified Ogilvie-Harris scoring scale. Results： None of the patients experienced recurrence of the subjective symptoms. Six months after the operation, the average score was 12.41, as compared with 2.53 before surgery ; 12 of the cases achieved excellent result, 3 good and 2 fair result ; the rate of excellent and good result was 88.2%. Conclusion ： Arthroscopic synoveetomy, with its advantages of minor invasiveness and rapid function recovery, can be the first choice for the treatment of diffused pigmented villonodular synovitis of the knee.

关 键 词：膝关节 色素沉着绒毛结节性滑膜炎 关节镜 滑膜切除术 

分 类 号：R686.7[医药卫生—骨科学]