关节镜在不同膝关节滑膜病变中的诊疗分析  

Application of arthroscope in diagnosis and treatment of knee synovitis

作　　者：王玉冰[1] 庞子轩 张亮[1] 康发军[1] 

机构地区：[1]河北省第七人民医院骨科,河北定州073000

出　　处：《局解手术学杂志》2014年第6期632-634,共3页Journal of Regional Anatomy and Operative Surgery

摘　　要：目的观察关节镜在不同膝关节滑膜病变中的诊断、治疗作用,分析不同病变的临床疗效。方法选取50例关节镜下诊断、治疗的膝关节滑膜病变患者为研究对象,术前拟诊为类风湿性关节炎10例,色素沉着绒毛结节性滑膜炎11例,膝关节慢性感染5例,慢性非特异性滑膜炎12例,膝关节滑膜结核5例,半月板损伤4例,不明原因3例,记录关节镜对膝关节滑膜病变的诊治效果。结果关节镜结合病理检查结果,术后10例患者更正临床诊断,所有伤口均一期愈合,无严重并发症发生。出院后所有患者均获得随访,6例色素沉着绒毛结节性滑膜炎,2例类风湿性关节炎,1例滑膜结核,1例慢性非特异性滑膜炎术后复发,其余患者术后膝关节功能均获得显著改善,总有效率80.0%。结论关节镜检查有利于明确诊断,而且微创可彻底切除病变的滑膜组织,耐受性好。Objective To investigate the value of arthroscope in the diagnosis and treatment of knee synovitis. Methods 50 cases of knee synovitis diagnosed by arthroscopy and treated by endoscopic synovectomy were studied. There were 10 cases with rheumatoid arthritis, 11 cases with pigmented villonodular synovitis,5 cases with chronic infection of knee joint,12 cases with chronic non-specific synovitis,5 ca-ses with tuberculous synovitis of the knee,4 cases with meniscus injury,3 cases with unknown cause. The efficacy of the treatment was recor-ded. Results All these cases were clearly diagnosed by microscopic examination combined with synovial pathological examination,and 10＆nbsp;cases were corrected with clinical diagnosis post-operation. All cases received primary healing without serious complications. All cases were followed up,and 6 cases of pigmented villonodular synovitis,2 cases of rheumatoid arthritis,1 case of chronic non-specific synovitis and 1 case of tuberculous synovitis of the knee had recurred. The total effective rate was 80. 0%. Conclusion The application of arthroscopy and syno-vial biopsy was effective in diagnosis. Arthroscopic synovectomy had good effect on treatment with less trauma and complications.

关 键 词：膝关节 滑膜病变 关节镜 诊断 

分 类 号：R687.4[医药卫生—骨科学]