关节镜与开放手术治疗足踝部PVNS的疗效比较  

Comparison of the Outcome of Arthroscopic and Open Surgery for the Treatment of Pigmented Villonodular Synovitis in the Ankle and Foot

作　　者：柳海峰[1] 杨雷[1] 李皓[1] 陆伟[1] 许鉴 欧阳侃[1] 钟名金 吴冰[1] 陈康[1] 李瑛[1] LIU Hai-feng;YANG Lei;LI Hao;LU Wei;XU Jian;OUYANG Kan;ZHONG Ming-jin;WU Bing;CHEN Kang;LI Ying(Shenzhen Second People＇s Hospital,Guangdong Shenzhen 518000)

机构地区：[1]深圳市第二人民医院,广东深圳518035

出　　处：《深圳中西医结合杂志》2018年第14期5-9,199,共6页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:观察关节镜与开放手术治疗足踝部色素沉着绒毛结节性滑膜炎(PVNS)的疗效。方法:回顾性分析2012年1月至2017年1月深圳市第二人民医院收治的25例足踝部PVNS患者,分为开放手术组13例,关节镜手术组12例。对两组患者手术时间、术中出血量、术后并发症(切口愈合不良、切口感染等)例数和住院时间、恢复完全负重时间、关节活动度、术前及术后1年视觉模拟评分法(VAS)评分、术前、术后1、3、6个月疗效[采用美国骨科足踝协会(AOFAS)踝与后足功能评分]和以及术后3年的复发率进行比较评价。结果:所有患者均得到随访,平均随访时间为(3.7±1.5)年。关节镜手术组的平均住院时间、平均恢复完全负重时间较开放手术组明显缩短,差异具有统计学意义(P<0.05)。关节镜手术组平均活动度优于开放手术组,差异具有统计学意义(P<0.05)。两组患者术后1、3、6个月AOFAS评分较术前均有明显改善,关节镜手术组明显优于开放手术组,差异具有统计学意义(P<0.05)。开放手术组术后3年内2例出现复发,而关节镜手术组无复发,差异具有统计学意义(P<0.05)。结论:关节镜手术联合术后放疗治疗足踝部PVNS的效果较开放手术更佳,复发率更低。Objective To compare the efficacy of arthroscopy and open surgery in the treatment of pigmented villonodular synovitis in the ankle and foot. Methods A retrospective analysis of 25 cases of PVNS patients admitted to the Second People＇s Hospital of Shenzhen from January 2012 to January 2017 was divided into open surgery group（n = 13） and arthroscopic surgery group（n = 12）. The operation time, intraoperative blood loss, postoperative complications（poor wound healing, wound infection, etc.） and length of hospital stay, total weight-bearing time, joint mobility, preoperative and postoperative 1-year visual analogue scale were compared between the two groups. The method（VAS） score, preoperative, postoperative 1, 3, and 6 months postoperative results（using the American Association of Orthopaedic Foot and Ankle（AOFAS） and hindfoot function scores] and the recurrence rate after 3 years of surgery were compared. Results All patients were followed up for an average of（3.7 ± 1.5） years. The average length of hospital stay and average weight-bearing time in the arthroscopic surgery group were significantly shorter than those in the open surgery group, and the difference was statistically significant（P〈0.05）. The average activity of the arthroscopic surgery group was better than that of the open surgery group, and the difference was statistically significant（P〈0.05）. The AOFAS scores of the two groups were significantly improved at 1, 3, and 6 months after surgery. The arthroscopic surgery group was significantly better than the open surgery group, and the difference was statistically significant（P〈0.05）. Two patients had recurrence within 3 years after operation in the open surgery group, but there was no recurrence in the arthroscopic surgery group（P〈0.05）. Conclusion Arthroscopic surgery combined with postoperative radiotherapy for the treatment of PVNS in the foot and ankle is better than open surgery and the recurrence rate is lower.

关 键 词：色素沉着绒毛结节性滑膜炎 关节镜术 开放手术 

分 类 号：R687.4[医药卫生—骨科学]