| 关节镜下滑膜切除术治疗类风湿性关节炎 |
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Received:June 28, 2005
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| 作者 | Author | 单位 | Unit | E-Mail |
| 章军辉 |
ZHANG Jun-hui |
宁波市第六医院骨科,浙江宁波315040 |
The 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
jhzhang933@sohu1.com |
| 狄正林 |
DI Zheng-lin |
宁波市第六医院骨科,浙江宁波315040 |
The 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 何志勇 |
HE Zhi-yong |
宁波市第六医院骨科,浙江宁波315040 |
The 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 冯建翔 |
FENG Jian-xiang |
宁波市第六医院骨科,浙江宁波315040 |
The 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 徐荣明 |
XU Rong-ming |
宁波市第六医院骨科,浙江宁波315040 |
The 6th Hospital of Ningbo,Ningbo 315040,Zhejiang,China |
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| 期刊信息：《中国骨伤》2006年19卷，第3期，第137-139页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:评价关节镜下滑膜切除术在治疗类风湿性关节炎中的价值。
方法:对40例早中期类风湿性关节炎48个膝关节(男10个,女38个,平均年龄35岁)在关节镜下行滑膜切除术,并使用双极射频汽化仪对残留的滑膜进行处理。术后给予羟基氯喹、氨甲喋呤和柳氮磺胺吡啶等抗类风湿药治疗,疗程6~12个月。48个关节均得到了6个月的随访,34个关节得到2年的随访。随访包括近侧指间关节的疼痛、关节压痛及关节肿胀的改善率;Ishikawa关节功能的评分;术前术后血沉(ESR)、C反应蛋白(CRP)和类风湿因子(RF)的检测。
结果:早期类风湿性关节炎以滑膜充血水肿为主要特点,中期类风湿性关节炎在镜下的表现是血管翳和肉芽肿的形成,术后6个月近侧指间关节的疼痛、关节压痛及关节肿胀的总改善率为83.3%,术后2年为55.9%。Ishikawa关节功能的评分术后6个月总优良率为93.8%,术后2年为73.5%。ESR、CRP和RF均较术前明显下降。
结论:对早中期类风湿性关节炎患者应进行关节镜下滑膜切除术,同时术后给予正规的药物治疗。 |
| [关键词]:关节镜手术操作 关节炎,类风湿 膝关节 |
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| Arthroscopic synovectomy for the treatment of rheumatoid arthritis |
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Abstract:
Objective:To study the value of arthroscopic synovectomy for the early and mid-stage rheumatoid arthritis(RA).
Methods:Forty-eight knees(male 10,female 38,with an average age of 35 years) in 40 cases with rheumatoid arthritis were treated with arthroscopic synovectomy and drug therapy of anti-rheumatoid after operation.Meanwhile the bipolar radiofrequency was used to remove synovium.All the 48 knees were followed up 6 months,among them,34 knees were followed up 2 years.Following up included:①ameliorative rate of the pain of proximal interphalangeal joint,tenderness and swelling of joint;②Ishikawa’s scoring system for knee function;③measurement of erythrocyte sedimentary rate(ESR),C-reactive protein(CRP) and rheumatoid factor(RF) before and after operation.
Results:The main behavior of the early RA under arthroscopy was synovial hyperemia and edema and the mid-stage RA was the formation of granuloma.The total ameliorative rate of the pain of proximal interphalangeal joint,tenderness and swelling of joint was 83.3% after operation 6 months and 55.9% after operation 2 years.The rate of excellent and good of Ishikawa’s scoring system was 93.8% after operation 6 months and 73.5% after operation 2 years.The level of ESR,CRP and RF significantly decreased in the different period.
Conclusion:Arthroscopic synovectomy is an important role in the treatment of early stage rheumatoid arthritis.Postoperative anti-rheumatoid drug therapy is also imperative. |
| KEYWORDS:Arthroscopic surgical procedures Arthritis,rheumatoid Knee joint |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 章军辉,狄正林,何志勇,冯建翔,徐荣明.关节镜下滑膜切除术治疗类风湿性关节炎[J].中国骨伤,2006,19(3):137~139 |
| 英文格式: | ZHANG Jun-hui,DI Zheng-lin,HE Zhi-yong,FENG Jian-xiang,XU Rong-ming.Arthroscopic synovectomy for the treatment of rheumatoid arthritis[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(3):137~139 |
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