CAJ | 학술논문

目的探讨腕关节镜下滑膜切除术治疗类风湿性腕关节炎的短期疗效.方法对20例类风湿性腕关节炎患者在腕关节镜下行滑膜切除术,其中男4例,女16例;年龄19 ～ 41岁,平均31岁.术中彻底清除桡腕关节、腕中关节、桡尺远侧关节内增生滑膜,冲洗关节腔.分别于术前、术后6周及术后12个月对患者腕关节疼痛情况应用疼痛视觉模拟评分(VAS)评估疼痛水平,术前及术后12个月测量腕关节屈伸活动度,对其进行比较.结果术中见腕关节中大量增生红色软组织血管翳,进行清除并冲洗关节腔.患者术后制动2d即早期活动,无明显腕关节僵硬发生.术后随访时间平均12个月(9～15个月).术前患者VAS评分平均为6分(4～8分);术后6周患者疼痛有所缓解,VAS评分平均为4分(3～7分);术后12个月时疼痛缓解明显,VAS评分平均为2分(1～4分).腕关节活动度明显增加,由术前平均65°增大到术后12个月时平均95°.结论腕关节镜下治疗类风湿性腕关节炎效果良好,有效缓解疼痛,增加腕关节活动度,患者对手术效果满意.具有推广应用前景.
목적 탐토완관절경하활막절제술치료류풍습성완관절염적단기료효.방법 대20례류풍습성완관절염환자재완관절경하행활막절제술,기중남4례,녀16례;년령19 ～ 41세,평균31세.술중철저청제뇨완관절、완중관절、뇨척원측관절내증생활막,충세관절강.분별우술전、술후6주급술후12개월대환자완관절동통정황응용동통시각모의평분(VAS)평고동통수평,술전급술후12개월측량완관절굴신활동도,대기진행비교.결과 술중견완관절중대량증생홍색연조직혈관예,진행청제병충세관절강.환자술후제동2d즉조기활동,무명현완관절강경발생.술후수방시간평균12개월(9～15개월).술전환자VAS평분평균위6분(4～8분);술후6주환자동통유소완해,VAS평분평균위4분(3～7분);술후12개월시동통완해명현,VAS평분평균위2분(1～4분).완관절활동도명현증가,유술전평균65°증대도술후12개월시평균95°.결론 완관절경하치료류풍습성완관절염효과량호,유효완해동통,증가완관절활동도,환자대수술효과만의.구유추엄응용전경.
Objective To evaluate the short-term effect of the arthroscopic synovectomy in treating rheumatoid arthritis of wrist.Methods Twenty rheumatoid patients including 4 men and 16 women aged 19 to 41 (mean,31) years old underwent the arthroscopic synovectomy of the radiocarpal joint,the midcarpal joint and the distal radioulnar joint.The visual analogue scale was used to evaluate the pain of the patients before surgery,6 weeks and 12 months after the surgery.The wrist flexion-extension arc was evaluated before and 12 months after surgery.Results Hypertrophy of the synovia and synovial pannus in the wrist was seen and resected during the surgery,and the articular cavity lavage was performed at the same time.The affected limb was immobilized for 2 days and started rehabilitation exercise.No ankylosis was seen in all 20 patients.The median duration of followup was 12 months,ranging from 9 to 15 months.6 weeks after the surgery the pain was relieved from VAS 6 points(range,4 to 8) to 4 points (range,3 to 7) on average,and 12 months after the surgery the VAS decreased to 2 points (range,1 to 4).The flexion-extension arc increased from 65° to 95° on average.Conclusion The arthroscopic synovectomy can obtain a satisfying outcome for rheumatoid arthritis patients,especially in relieving pain and increasing the wrist motion.The surgery is well accepted by patients and has a promising future in clinical treatment.