髋关节滑膜软骨瘤病25例手术治疗临床分析  

Clinical analysis of surgical treatment of 25 cases of synovial chondromatosis of hip joint

作　　者：段连鸿 程丽 黄晓华 田大为 李巍 DUAN Lian-hong;CHENG Li;HUANG Xiao-hua;TIAN Da-wei;LI Wei(Department of Orthopaedics, Dongfeng Hospital Affiliated to Hubei University of Medicine, Shiyan 442008, Hubei, CHINA)

机构地区：[1]湖北医药学院附属东风医院骨科,湖北十堰442008

出　　处：《海南医学》2019年第10期1316-1319,共4页Hainan Medical Journal

摘　　要：目的探讨髋关节滑膜软骨瘤病的发病机制、临床诊断及治疗策略。方法回顾性分析湖北医药学院附属东风医院骨科2012年2月至2017年7月期间经手术治疗的25例髋关节滑膜软骨瘤病患者的临床诊治资料,其中采用传统开放性手术15例,关节镜手术10例,均同时行滑膜切除。结果所有患者术后随访12个月,切口均Ⅰ期愈合,术前及末次随访VAS评分为(4.5±1.2)分和(1.7±0.8)分;髋关节Harris评分为(64.2±8.1)分及(91.6±6.7)分;末次随访时关节镜手术患者的Harris评分为(85.1±7.3)分,优于开放性手术的(92.3±6.5)分,差异具有统计学意义(P<0.05);末次随访时2例"4"字试验阳性,1例Thomas征阳性,其余病例均无明显阳性体征,X线片复查示患者均无复发征象,MRI复查示所有患者存在不同程度关节积液。结论外科手术是治疗髋关节滑膜软骨瘤病的有效手段,且采用关节镜手术具有创伤小、恢复快等优点,可以提高临床疗效及患者满意度。Objective To investigate the pathogenesis, clinical diagnosis and treatment strategy of synovial chondromatosis of hip joint.Methods The clinical data of diagnosis and treatment of 25 patients with hip synovial chondromatosis were retrospectively analyzed, who underwent surgery in the Department of Orthopaedics at Dongfeng Hospital Affiliated to Hubei University of Medicine from February 2012 to July 2017, including 15 cases of traditional open surgery and 10 cases of arthroscopic surgery. All underwent synovial resection at the same time. Results All patients were followed up for 12 months, and all incisions were healed by first intention. Before and at the last follow-up,the VAS score was respectively 4.5±1.2 and 1.7±0.8;the Harris score of hip joint was 64.2±8.1 and 91.6±6.7, respectively. At the last follow-up, the Harris score of patients undergoing arthroscopic surgery was 85.1 ± 7.3, which was better than 92.3±6.5 of open surgery(P<0.05). At the last follow-up, 2 patients were positive in the "figure-4" test, 1 patient was positive for Thomas sign, and the other patients had no obvious positive signs. X-ray re-examination showed no signs of recurrence in all patients, and MRI re-examination showed that all patients had different degrees of joint effusion. Conclusion Surgery is an effective method for the treatment of synovial chondromatosis of the hip joint. The use of arthroscopic surgery has the advantages of small trauma and quick recovery, which can improve clinical efficacy and patient satisfaction.

关 键 词：滑膜软骨瘤 开放手术 关节镜手术 髋关节功能 临床疗效 

分 类 号：R738.3[医药卫生—肿瘤]