类风湿关节炎与复发性多软骨炎致环杓关节固定的诊断与治疗  

THE DIAGNOSIS AND TREATMENT ABOUT RHEUMATOID ARTHRITIS AND RELAPSING POLYCHONDRITIS INVOLVING CRICO-ARYTENOID ARTICULATION

作　　者：张俊中[1] 常荣先[2] 

机构地区：[1]扬州大学医学院附属医院,扬州225001 [2]上海复旦大学附属中山医院,上海200032

出　　处：《江苏临床医学杂志》2001年第6期494-497,共4页Journal of Jiangsu Clinical Medicine

摘　　要：目的 :探讨类风湿性关节炎 (RA)和复发性多软骨炎 (RP)的临床特点、诊断与鉴别诊断以及治疗与预后 ,以提高对RA和RP的认识。方法 :回顾性分析 11例RA和 15例RP患者的临床资料。结果 :1991～ 2 0 0 0年间收治 11例RA和 15例RP中 ,分别有 4例 ( 36 %)和 5例 ( 33%)累及双侧环杓关节。RP中 6 0 %有耳软骨炎 ,33%有鼻软骨炎 ,47%有呼吸系统受累 ,部分患者有心血管受累 ,用皮质激素、免疫抑制和氨苯砜控制症状 ,4例RA和 5例RP患者因呼吸道梗阻行气管切开术 ,3例RA患者行杓状软骨切除声带外展移位术。 15例RP中 1例治疗无效 ,死于呼吸道并发症。结论 :RA、RP是自身免疫性疾病 ,可累及多器官的软骨结构及结缔组织 ,在耳鼻喉科有表现 ,易误诊。早期诊断 ,采用综合治疗是提高疗效改善预后的关键。Objective:To investigate the clinical causes,diagnosis, treatments and prognosis of rheumatoid arthritis(RA) and relapsing polychondritis(RP) involving otolaryngology.Methods:11 patients with RA and 15 with RP were reviewed retrospectively.Results:From 1991 to 2000,11 patients with RA and 15 with RP were managed in this hospital.Of them,4(36%) with RA and 5(33%) with RP involving bilateral crico-arytenoid articulation were observed.Of the patients with RP,60% had auricular chondritis,42% nasal chondritis,47% respiratory system and some cardiovascular system involved.Coticosteroids,immunosuppressive agents and dapsone were used in these patients.Due to airway obstruction,tracheotomy was performed in 4 patients with RA and 5 with RP.Abduction transposition of vocal cord was performed in 3 patients with RA.Of 15 cases with RP,1 died from respiratory complications.Conclusion:RA and RP is an autoimmune disease and usually misdiagnosed.Early diagnosis and combined treatment can improve the prognosis and enhance the curative effect.

关 键 词：多发性软骨炎 类风湿性关节炎 环杓关节固定 声带外展移位术 诊断 

分 类 号：R593.22[医药卫生—内科学] R681.3[医药卫生—临床医学]