关节镜下治疗单纯滑膜结核的临床效果观察

Clinical effect observation of arthroscopic treatment of simple synovial tuberculosis

目的观察和评价关节镜下治疗单纯滑膜结核的临床效果。方法单纯滑膜结核患者32例,将其随机分为观察组与对照组,每组16例,其中对照组患者接受单纯关节镜下滑膜切除治疗,观察组患者接受关节镜下滑膜切除手术及活检治疗,并在术后进行关节腔异烟肼注射及全身抗结核治疗,治疗随访6~24个月,观察两组患者的治疗效果。结果通过病理检查确诊,两组患者均为滑膜结核。两组患者治疗后关节症状有十分明显的改善,关节屈曲与伸直幅度均有明显提高,和治疗前相比,差异具有统计学意义（P〈0.05）,观察组治疗效果明显优于对照组,差异具有统计学意义（P〈0.05）。结论关节镜下切除滑膜,并将肉芽组织清理与抗结核药物治疗相结合,可显著改善关节功能,治疗效果良好,值得临床推广应用。

Objective To observe and evaluate the clinical effect of arthroscopic treatment of simple synovial tuberculosis. Methods A total of 32 patients with simple synovial tuberculosis were randomly divided into observation group and control group, with 16 cases in each group. The control group received arthroscopic synovectomy, while the observation group was given arthroscopic synovectomy and biopsy treatment with postoperative articular cavity isoniazid injection and systemic anti-tuberculosis treatment. Follow-up lasted for 6~24 months, and curative effects of the two groups were observed. Results By pathological diagnosis, both groups were synovial tuberculosis, and they all gained obvious improvement of joint symptoms. Their knee flexion and extended range were all improved. Compared with those before treatment, the difference after treatment had statistical significance（P〈0.05）. The observation group had better curative effect than the control group, and the difference had statistical significance（P〈0.05）. Conclusion The combination of arthroscopic synovectomy, granulation tissue clean, and anti-tuberculosis drugs treatment can remarkably improve joint function with good curative effect. It is worth clinical promotion and application.