腘窝囊肿的发病机制及其针对性治疗

Pathogenesis and treatment of popliteal cyst

目的:分析腘窝囊肿的发病途径,评估临床诊治腘窝囊肿的最佳方案。资料来源:应用计算机检索Medline1990-01/2005-12腘窝囊肿的相关文献,检索词为“poplitealcyst”,限定文章语言种类为English;同时计算机检索CHKD数据库1994-01/2005-12中腘窝囊肿的相关文献,检索词为“腘窝囊肿”,限定文章语言种类为中文。资料选择:对符合研究目的文献进行初审。纳入条件:①临床病例≥30例,随访不少于12个月的临床研究。②有特殊意义的个案报告。排除条件:①重复研究。②综述文献。资料提炼:共收集到有关腘窝囊肿的文献55篇。符合纳入条件的24篇,排除31篇。资料综合:24篇文献分别对腘窝囊肿的发病机制、诊断及治疗进展进行评价。腘窝囊肿可分为原发性和继发性两种类型,结合病史、临床表现及辅助检查较易确诊,单纯囊肿切除复发率较高,近年来应用关节镜处理关节内病变显示出优势,术中观察结果有助于深入研究发病途径。结论:膝关节内病变是腘窝囊肿的形成和持续存在的重要因素,超声或MRI检查有利于明确诊断和指导制定治疗方案,穿刺抽吸药物注射需慎重进行,关节镜下微创治疗是当前发展的方向,特殊情况下需联合切开手术。

OBJECTIVE： To research the pathogenesis and appropriate clinical therapeutics of popliteal cyst. DATA SOURCES： Using the key words of ＂popliteal cyst＂, we searched the Medline database the relevant articles about popliteal cyst published in English from January 1990 to December 2005. Meanwhile, we retrieved the CHKD for Chinese articles about popliteal cyst from January 1990 to December 2005 with the same key words in Chinese. STUDY SELECTION： The literatures met the research object were selected firstly. Inclusive criteria： ①clinical studies, in which the number of cases was more than 30, and the follow-up was longer than 12 months. ②special case report. Exclusive criteria：①repeated studies; ②review articles. DATA EXTRACTION： Totally 55 articles on popliteal cyst were collected, of which 24 ones were accorded with the inclusive criteria, and 31 articles were excluded. DATA SYNTHESIS： The 24 articles evaluated the pathogenesis, diagnosis and treatment of popliteal cyst, respectively. Popliteal cyst were distinguished as primary and idiopathic cyst. The diagnosis could be made easily according to history, clinical symptoms and some auxiliary examination. There was a high recurrence after simple surgical removal of the cysts, in recent years, some studies showed the superiority of the arthroscopic treatment, the observation in which was helpful to further research on pathogenesis of popliteal cyst. CONCLUSION： The associated intra-articular disorder is the factor responsible for the formation and persistence of cyst. Sonography or magnetic resonance imaging is important to identify the type of condition and determine the therapeutic plan. Drainage of the contents of cysts and injection of drug should be carried out prudently. Although arthroscopic treatment is the prevalent therapeutic direction today, for some special conditions combination of arthroscopic and open procedure is necessary.