手、足腱鞘结核的诊治分析

Diagnosis and Treatment of Tuberculosis in Hand or Foot Synovial Sheath

目的探讨原发性手、足部的腱鞘结核的临床特点,腱鞘肿物的诊断及治疗要点。方法 2002年10月至2009年3月,对6例手、腕、足踝部的核性腱鞘炎患者采用手术、抗结核药物及功能锻炼等综合治疗后,分析其临床疗效、误诊原因和诊治要点。结果全部病例均治愈。术后随访1～6年,5例效果满意,1例因复发2次导致功能部分受限。结论结核性腱鞘炎诊断依靠临床表现和实验室检查同时进行分析。及时的病灶清除术、加上系统的抗结核药物和功能锻炼等综合治疗,可以完全治愈。

Objective To investigate feature on the diagnosis and treatment of hand or foot tuberculous tenosynovitis. Methods From October 2002 to March 2009, 5 cases of tuberculous tenosynovitis at thehand were treated with surgery and antitubereular agents. The outcomes, misdiagnosed reason and treatment points were analyzed respectively. Results All cases were cured. Excellent function was obtained in 5 cases after postoperative 1 to 6 years of follow up. There was 1 case with somewhat disability because of recurrence 2 times. Conclusions Early diagnosis of tuberculous tenosynovitis depends on the clinical manifestation and lab test. Healing could be achieved if focal cleaning, antitubercular medication and functional rehabilitation ware performed on time.