膝关节内滑膜血管瘤的关节镜下诊断与治疗

Diagnosis and treatment of intra-articular synovial hemangioma of the knee under arthroscopy

目的提高对滑膜血管瘤诊断的认识和治疗.方法回顾总结1994年以来关节镜下发现诊断的3例膝关节骨滑膜血管瘤的诊治经过,经一年以上的随访,进行疗效观察.结果 3例术前均误诊,全部在膝关节镜检查中发现后确诊,并经病理证实,镜检同时一期行关节镜下手术,术中配以钬激光应用,使血管瘤萎缩、闭塞、消融.术后随访8N～54个月,关节活动正常,肿胀和伸直障碍症状消失,关节自发性积液症状无复发,疗效满意.结论关节内滑膜血管瘤十分罕见,临床诊断较为困难,误诊率高.随着关节镜技术的不断提高和MRI的广泛应用,关节内滑膜血管瘤的诊断将会获得提高,而钬激光的应用亦为其治疗提供了一个更广阔的前景.

Objective: To introduce the diagnosis and treatment of intra-articular synovial hemangioma. Methods: 3 cases with intra-articular synovial hemangioma of knee had been diagnosed and treated under arthroscopy since 1994. The synovial hemangioma were removed under arthroscopy and its residual would be atrophy, occlusion and disappearence with the application of Ho: YAG. All the patients were followed up more than one year for advanced therapeutical evaluation. Results: The diagnoses of hemangioma for 3 cases were not established until arthroscpopy were performed and post operative pathologic results. All patients were satisfied with their therapeutical effects. They acquired normal joint movements, joint swelling and extension imparirment vanished, no recurrence of spontaneous joint effusion. Conclusions: Intra-articular synovial hemangioma is very rare so its clinical diagnosis is very difficult and its misdiagnosis rate is very high. With the development of arthroscopy and extensive application of MRI, the diagnosis of intra-articular synovial hemangioma will be improved significantly and the application of Ho: YAG will provide a good therapy prospect.