关节镜在膝关节化脓性关节炎诊治中的临床应用

Effect of Arthroscopy on Diagnosing and Treating Suppurative Arthritis of Knee Joint

目的总结膝关节镜下清理及术后持续灌洗引流治疗膝关节化脓性关节炎的方法及疗效。方法 2012年1月-2013年12月共收治膝关节化脓性关节炎22例,其中男13例,女9例;年龄7~56岁,平均28.5岁;病史7 d^4.5个月,平均2.8个月;均有不同程度的膝关节红肿、疼痛及关节活动受限;20例明确诊断,2例为骨关节炎穿刺治疗感染不典型病例;随访时利用Lysholm评分对膝关节功能进行评价,同时对其临床资料进行回顾性分析。结果 22例患者随访3~10个月,平均8.5个月;术后均经镜下和病理确诊;均无复发。Lysholm评分77~99分,平均92.8分。仅1例慢性化脓性关节炎患者经多次治疗,关节活动范围10~40°。结论早期应用关节镜治疗膝关节化脓性关节炎,术后持续灌洗引流,配合综合康复锻炼,临床效果满意,具有创伤小、病灶清除彻底、可最大限度保留膝关节功能、恢复快、疗效好等优点,是值得临床推广的一种治疗方法。

Objective To explore the ef ect of arthroscopy on diagnosing and treating suppurative arthritis of knee joint.Methods The clinical data of 22 patients with suppurative arthritis of knee joint diagnosed between January 2012 and December 2013 were analyzed retrospectively,including 13 males and 9 females with the age of 7-56 years（average 28.5 years）.The duration of disease history was from 7 days to 4.5 months with the average of 2.8 months.All of the patients had swelling,pain,and limitation of motion of the knee joint in dif erent degrees.Among them,20 patients were diagnosed definitely and remaining 2 were osteoarthritis with atypical infections.Patients were investigated by Lysholm questionnaires during the follow-up period.Results All of the 22 patients were followed up for 3-10 months with the average of 8.5 months.The diagnosis was confirmed by pathological and arthroscopic examination after the surgery,and no recurrence was found.Lysholm score ranged from 77 to 99 with the average of 92.8.Only 1 patient had the motion range of 10-40°of the knee joint at er several treatment.Conclusion Early arthroscopic treatment for suppurative arthritis of knee joint with continuous postoperative lavage and irrigation combined with comprehensive physiotherapy and rehabilitation has the advantages of high efficacy,maximum recovery of knee function,and quick recovery,which should be promoted in the clinical application