类风湿关节炎合并腘窝囊肿术后不愈合临床分析

Clinical Analysis of Nonunion after Operation of Rheumatoid Arthritis Combined with Popliteal Cyst

目的 探讨类风湿关节炎合并腘窝囊肿术后不愈合的原因。方法 对2019年9月—2022年4月收治的类风湿关节炎合并腘窝囊肿术后不愈合6例的临床资料进行回顾性分析。结果 6例均因腘窝囊肿于外院行开放切除术后出现切口不愈合、分泌物渗出等症状就诊我院,经询问病史及相关检查发现类风湿关节炎病史未确诊至20年,合并膝骨关节炎3例,术后切口不愈合病程20~62 d,入院后均予抗风湿、抗感染及局部清创治疗,切口愈合良好,类风湿关节炎疾病活动度降低。结论 忽视类风湿关节炎病情活动,未选择合理的外科干预方式及围术期诊疗不规范是导致类风湿关节炎合并腘窝囊肿切除术后不愈合的主要原因。

Objective To investigate the causes of nonunion after operation for rheumatoid arthritis combined with popliteal cyst.Methods The clinical data of 6 patients with postoperative nonunion after operation for rheumatoid arthritis with popliteal cyst admitted from September 2019 to April 2022 were retrospectively analyzed.Results Six patients with popliteal cyst presented with wound nonunion and exudation after open resection in other hospitals.After inquiring about the medical history and relevant examinations,it was found that the history of rheumatoid arthritis was not confirmed until 20 years.Three cases were complicated with knee osteoarthritis.The course of wound nonunion after operation was 20 to 62 d.All patients were treated with anti-rheumatism,anti-infection and local debridement,with good incision healing and reduced activity of primary disease.Conclusion The main reasons for the nonunion after resection for rheumatoid arthritis combined with popliteal cyst include the negligence of the disease activity of rheumatoid arthritis,the non-selection of reasonable surgical intervention and the non-standard perioperative diagnosis and treatment.