CAJ | 학술논문

目的探讨关节镜在儿童髋关节一过性滑膜炎治疗中的应用价值.方法2009年6月至2012年6月福建省厦门大学附属第一医院采用髋关节镜治疗11例(13髋)儿童髋关节一过性滑膜炎.关节镜下观察髋关节内容物病理学表现,清理增生滑膜,冲洗关节腔.术后评估患者症状改善及并发症发生情况.结果关节镜下主要表现:11例(13髋)关节滑膜广泛增生、呈暗红色;5例(5髋)增生滑膜包绕圆韧带,双侧髋臼内有纤维条索样组织填充.术后病理检查示滑膜组织充血、水肿,无明显炎性细胞浸润.所有患者获得完整随访,随访时间5~10个月,平均随访时间7.5个月.患者术后3周正常关节活动范围基本恢复,6周疼痛症状消失,3个月跛行、无法着地站立等症状基本消失.未见血管、神经损伤及皮肤坏死等并发症发生.随访期间无复发病例.结论髋关节镜微创技术具有镜下观察病理学表现、彻底清理髋关节内病变和增生滑膜等特点,诊断明确、疗效满意,是治疗儿童髋关节一过性滑膜炎较好的选择.
목적탐토관절경재인동관관절일과성활막염치료중적응용개치.방법2009년6월지2012년6월복건성하문대학부속제일의원채용관관절경치료11례(13관)인동관관절일과성활막염.관절경하관찰관관절내용물병이학표현,청리증생활막,충세관절강.술후평고환자증상개선급병발증발생정황.결과관절경하주요표현:11례(13관)관절활막엄범증생、정암홍색;5례(5관)증생활막포요원인대,쌍측관구내유섬유조색양조직전충.술후병리검사시활막조직충혈、수종,무명현염성세포침윤.소유환자획득완정수방,수방시간5~10개월,평균수방시간7.5개월.환자술후3주정상관절활동범위기본회복,6주동통증상소실,3개월파행、무법착지참립등증상기본소실.미견혈관、신경손상급피부배사등병발증발생.수방기간무복발병례.결론관관절경미창기술구유경하관찰병이학표현、철저청리관관절내병변화증생활막등특점,진단명학、료효만의,시치료인동관관절일과성활막염교호적선택.
Objective To discuss the application value of arthroscopy for the treatment of transient synovitis of hip joint in children. Methods From June 2009 to June 2012, 11 patients (13 hips) were treated by hip arthroscopy in the First Affliated Hospital of Xiamen University. Pathological manifestations of hip joint were observed under arthroscope, the thickened synovium was cleaned and the articular cavity was washed, the improvement of symptom and the complications were evaluated after the surgery. Results Under the scope, there were extensive proliferation of synovium which showed dark red in 11 patients (13 hips), round ligament enclosed by proliferative synovial membranes in 5 patients (5 hips), with fibrous cord-like tissue in bilateral acetabulum. Postoperative pathological examination showed hyperemia and edema in synovial membranes, without obvious inflammatory cells infiltration. All patients were followed up from 5-10 months, with the average of 7.5 months. Range of motion of hip joint was recovered at 3 weeks after surgery, symptom of pain disappeared after 6 weeks, symptoms of limp and disability of bearing weight also disappeared after 3 months. There were no complications of vascular, nerve injuries or skin necrosis, and no recurrent cases had happened during the follow-up. Conclusions For the treatment of hip transient synovitis in children, hip arthroscopy is a comparable choice with the advantages of accurate diagnosis and good efficacy, due to arthroscopic observation of pathological manifestation, and thorough cleaning of hip joint lesion and proliferative synovium.