关节镜下诊断和治疗膝关节滑膜炎的临床分析

Clinical study on arthroscopic examination in diagnosis and treatment of knee synovitis

目的探讨关节镜对膝关节滑膜炎的诊断和治疗价值。方法对35例膝关节滑膜炎患者进行关节镜检查明确诊断,进行镜下滑膜切除术,观察疗效。结果镜检结合滑膜病理,明确诊断病例为:18例类风湿性关节炎,8例慢性非特异性滑膜炎,4例色素沉着绒毛结节性滑膜炎,3例关节结核,2例慢性化脓性关节炎。滑膜切除术后随访6～40个月,平均随访26个月。疗效优者20例(57.1%),良10例(28.6%)和差5例(14.3%)。结论关节镜检查及滑膜活检可明显提高滑膜炎的诊断率,关节镜下滑膜切除术治疗膝关节滑膜炎疗效较好,创伤小,并发症很少,是一种理想的外科治疗方法。

Objective To study and analyze the significance and clinical efficacy of arthroscopic examination in diagnosis and treatment of knee synovitis. Methods A total of 35 patients with knee synovitis were diagnosed by arthroscopy and treated by endoscopic synovectomy. Results AU these cases were clearly diagnosed by microscopic examination combined with synovial pathological examination： 18 cases of rheumatoid arthritis, 8 cases of chronic non - specific synovitis, 4 cases of pigmented villonodular synovitis, 3 cases of joint tuberculosis, and 2 cases of chronic suppurant arthritis. These patients after synovectomy were followed up for 6 to 40 months, with an average follow - up period of 26 months. The excellent efficacy was seen in 20 cases （57.1% ）, good in 10 cases （28.6%） and poor in 5 cases （ 14.3% ）. Conclusion The application of arthrosoopy and synovial biopsy can significantly raise the diagnostic rate of synovitis. Arthroscopic synovectomy in treatment of knee synovitis has good efficacy with less trauma and complications. It is an ideal surgical approach.