中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
10期
1511-1513
,共3页
王利%殷剑%哈巴西%赵巍%袁宏
王利%慇劍%哈巴西%趙巍%袁宏
왕리%은검%합파서%조외%원굉
滑膜炎,色素绒毛结节性%膝关节,人工%关节镜下滑膜切除术
滑膜炎,色素絨毛結節性%膝關節,人工%關節鏡下滑膜切除術
활막염,색소융모결절성%슬관절,인공%관절경하활막절제술
Pigmentedvillonodular synovitis%Knee arthroplasty%Arthroscopic synovectomy
目的 分析全膝关节置换术、关节镜下滑膜组织切除术对膝关节色素沉着绒毛结节性滑膜炎(PVNS)的临床治疗效果.方法 对2011年3月至2013年3月收治的PVNS行外科治疗患者30例[行关节镜手术者20例(关节镜组),行全膝关节置换术者10例(全膝关节置换组)]进行回顾性分析,通过分析术前及术后随访结果,比较2组术后关节功能改善情况.结果 关节镜组绒毛型、结节型和混昆合型分别为6、12和2例;全膝关节置换组分别为3、2和5例.关节镜组术后8个月Lysholm评分和关节屈伸活动度均高于术前,差异有统计学意义[分别为(89±11)分比(60±8)分,t=-7.79,P＜0.01;(108±16).比(72±12).,t=-3.54,P＜0.01].全膝关节置换组术后的HSS评分和关节屈伸活动度也明显高与术前[分别为(84±11)分比(64±5)分,t=-5.75,P＜0.01;(132±18).比(69±12).,t=-3.54,P＜0.01],且全膝关节置换组的关节屈伸活动度术后明显好于关节镜组患者,差异有统计学意义(P＜0.05).术后8个月关节镜组和全膝关节置换组国际膝关节评分委员会膝关节评估表评分均高于术前[分别为(81 ±11)分比(62±10),(93±13)分比(58±9)分,均P＜0.01],且全膝关节置换组术后高于关节镜组,差异有统计学意义(P＜0.01).术后2组患者均未见复发.结论 全膝关节置换术治疗不同程度PVNS的效果好于关节镜下滑膜组织切除术,可有效改善临床症状.
目的 分析全膝關節置換術、關節鏡下滑膜組織切除術對膝關節色素沉著絨毛結節性滑膜炎(PVNS)的臨床治療效果.方法 對2011年3月至2013年3月收治的PVNS行外科治療患者30例[行關節鏡手術者20例(關節鏡組),行全膝關節置換術者10例(全膝關節置換組)]進行迴顧性分析,通過分析術前及術後隨訪結果,比較2組術後關節功能改善情況.結果 關節鏡組絨毛型、結節型和混昆閤型分彆為6、12和2例;全膝關節置換組分彆為3、2和5例.關節鏡組術後8箇月Lysholm評分和關節屈伸活動度均高于術前,差異有統計學意義[分彆為(89±11)分比(60±8)分,t=-7.79,P＜0.01;(108±16).比(72±12).,t=-3.54,P＜0.01].全膝關節置換組術後的HSS評分和關節屈伸活動度也明顯高與術前[分彆為(84±11)分比(64±5)分,t=-5.75,P＜0.01;(132±18).比(69±12).,t=-3.54,P＜0.01],且全膝關節置換組的關節屈伸活動度術後明顯好于關節鏡組患者,差異有統計學意義(P＜0.05).術後8箇月關節鏡組和全膝關節置換組國際膝關節評分委員會膝關節評估錶評分均高于術前[分彆為(81 ±11)分比(62±10),(93±13)分比(58±9)分,均P＜0.01],且全膝關節置換組術後高于關節鏡組,差異有統計學意義(P＜0.01).術後2組患者均未見複髮.結論 全膝關節置換術治療不同程度PVNS的效果好于關節鏡下滑膜組織切除術,可有效改善臨床癥狀.
목적 분석전슬관절치환술、관절경하활막조직절제술대슬관절색소침착융모결절성활막염(PVNS)적림상치료효과.방법 대2011년3월지2013년3월수치적PVNS행외과치료환자30례[행관절경수술자20례(관절경조),행전슬관절치환술자10례(전슬관절치환조)]진행회고성분석,통과분석술전급술후수방결과,비교2조술후관절공능개선정황.결과 관절경조융모형、결절형화혼곤합형분별위6、12화2례;전슬관절치환조분별위3、2화5례.관절경조술후8개월Lysholm평분화관절굴신활동도균고우술전,차이유통계학의의[분별위(89±11)분비(60±8)분,t=-7.79,P＜0.01;(108±16).비(72±12).,t=-3.54,P＜0.01].전슬관절치환조술후적HSS평분화관절굴신활동도야명현고여술전[분별위(84±11)분비(64±5)분,t=-5.75,P＜0.01;(132±18).비(69±12).,t=-3.54,P＜0.01],차전슬관절치환조적관절굴신활동도술후명현호우관절경조환자,차이유통계학의의(P＜0.05).술후8개월관절경조화전슬관절치환조국제슬관절평분위원회슬관절평고표평분균고우술전[분별위(81 ±11)분비(62±10),(93±13)분비(58±9)분,균P＜0.01],차전슬관절치환조술후고우관절경조,차이유통계학의의(P＜0.01).술후2조환자균미견복발.결론 전슬관절치환술치료불동정도PVNS적효과호우관절경하활막조직절제술,가유효개선림상증상.
Objective To retrospectively analyze the clinical effects of total knee replacement surgery and arthroscopic resection of the knee joint synovial tissue in pigmentation villonodular synovitis.Methods Patients with pigmented villonodular synovitis treated by surgery pigment from March 2011 to March 2013 were selected and the clinical data was analyzed retrospectively.Results Hair type,nodular type and mixed type in arthroscopy synovectomy group were 6 cases,12 cases,2 cases respectively; those in the total knee replacement group were 3 cases,2 cases and 5 cases respectively.The imaging results were in accordance with Gitelis classification;there were 12 cases of grade 1 change,8 cases of 2 level change in the arthroscopy synovectomy group; 1 case was level 2 change and 9 cases was level 3 changes in the total knee replacement group.The Lysholm score and range of motion in arthroscopy synovectomy group were significantly higher than before [(89 ± 11) vs (60 ± 8),t =-7.79,P ＜0.01 ; (108 ± 16) ° vs (72 ± 12) °,t =-3.54,P ＜0.01].The HSS score and range of motion in total knee replacement group were significantly higher than before [(84 ± 11) scores vs (64 ± 5) scores,t =-5.75,P ＜ 0.01 ;(132 ±18)° vs (69 ± 12)°,t =-3.54,P ＜0.01].Range of motion in the total knee replacement group were clearly better than those in arthroscopy synovectomy group (P ＜ 0.05).The IKDC scores after 8 months in the two group were both significantly higher than before (P ＜ 0.05).IKDC scores in the total knee replacement group were significantly higher than those in arthroscopy synovectomy group and the difference was statistically significant(P ＜0.05).No recurrence was found in both group.Conclusion Total knee replacement surgery and arthroscopic synovial tissue resection are effective in treating various degrees of knee pigmented villonodular synovitis with low recurrence rate.
