肩关节色素沉着绒毛结节性滑膜炎的关节镜治疗  

Arthroscopic treatment of pigmented villonodular synovitis of shoulder joint

作　　者：曲振安 王卫明 穆金燕[2] 马霄君[2] 李丹妹 QU Zhen-an;WANG Wei-ming;MU Jin-yan;MA Xiao-jun;LI Dan-mei(Zunyi Medical University,Zunyi 563003,Guizhou,CHINA;Department of Sport Medicine,Affiliated Zhongshan Hospital of Dalian University,Dalian 116001,Liaoning,CHINA)

机构地区：[1]遵义医科大学,贵州遵义563003 [2]大连大学附属中山医院运动医学科,辽宁大连116001

出　　处：《海南医学》2020年第11期1439-1442,共4页Hainan Medical Journal

摘　　要：目的探讨应用肩关节镜技术治疗肩关节色素沉着绒毛结节性滑膜炎(PVNS)的方法及其临床效果。方法回顾性分析2017年1月至2018年6月大连大学附属中山医院运动医学科收治的5例PVNS (其中弥漫型4例,局灶型1例)患者临床诊治资料,所有患者均行关节镜下滑膜清除及肩峰下滑囊切除,肩峰成形术,并对其中4例进行肩袖修补术。术后进行系统的康复训练。所有患者均在术前及术后1年随访时采用Constant评分、美国肩肘外科协会(ASES)评分、疼痛视觉模拟评分(VAS)进行主观评估;术前及术后3、6、12个月随访时行肩关节MRI检查和肩袖超声进行影像学评价。结果 5例患者获得平均14.5个月的随访,肩部疼痛和功能障碍消失或明显改善;患者Constant评分从术前的(45.8±15.6)分提高至术后的(97.4±13.4)分,ASES评分从术前的(28±5.4)分提高至术后的(95.2±11.3)分,VAS疼痛评分从术前的(8.0±0.7)分降低至术后的(1.0±0.7)分,差异均有统计学意义(P<0.05);术后1年影像学检查提示炎症无复发。结论肩关节镜下治疗色素沉着绒毛结节性滑膜炎是一种损伤小、恢复快并且有效的方法。Objective To investigate the indications,surgical techniques,and results of arthroscopic treatment of pigmented villonodular synovitis.Methods The clinical data of 5 cases of pigmented villonodular synovitis(4 cases of diffused type,1 case of localized type)treated in Department of Sport Medicine,Affiliated Zhongshan Hospital of Dalian University were retrospectively analyzed.All patients underwent arthroscopic debridement of the synovium and subacromial decompression,and acromioplasty of shoulder(5 cases),rotator cuff neoplasty(4 cases).Systematic rehabilitation program were followed.The preoperative and postoperative clinical date such as Constant’s score,Visual Analog Scale(VAS)score,MRI and ultrasonography of the rotator cuff were performed before and 3,6,12 months after operation.Results All patients were followed up for an average of 12.5 months,and pain and functional disturbance of the shoulder disappeared or obviously improved.The Constant score increased from(45.8±15.6)points before operation to(97.4±13.4)points after operation.The ASES score increased from(28±5.4)points before operation to(95.2±11.3)points after operation.The VAS score decreases from(8.0±0.7)points before operation to(1.0±0.7)points after operation.All the scoring systems revealed a significant difference before and after surgery.Conclusion In case of pigmented villonodular synovitis of the shoulder joint,arthroscopical total synovectomy is an effective and minimally invasive method.

关 键 词：肩关节 色素沉着绒毛结节性滑膜炎 关节镜 关节镜下滑膜切除术 肩袖撕裂 

分 类 号：R686.7[医药卫生—骨科学]