摘要
目的探讨膝关节镜诊治小儿单膝关节滑膜炎的临床效果。方法 2013年1月~2017年4月使用2.7 mm,30°关节镜对37例1.5~13.5岁单膝关节滑膜炎患儿行关节镜探查术,术中取滑膜送病理检查,根据病理结果施行相应治疗。结果 37例手术顺利完成,手术时间30~60 min(平均45 min),均无血管、神经损伤及感染等并发症。术后诊断32例为幼年特发性关节炎(1例伴关节软骨破坏,17例转风湿免疫科药物治疗),2例为色素绒毛结节滑膜炎,2例为结核性滑膜炎(术后转结核病院治疗),1例为半月板损伤。住院时间3~7 d(平均5 d)。22例随访0.5~4年,平均2.3年,优11例,良7例,可3例,差1例,优良率81.8%(18/22)。结论关节镜诊治小儿单膝关节滑膜炎疗效满意。
Objective To explore the clinical effect of arthroscopic diagnosis and treatment of children＇s single knee synovitis. Methods From January 2013 to April 2017,37 patients with single knee synovitis aged from 1. 5 to 13. 5 years old underwent arthroscopic exploration. The operation consisted of following steps： exploring the condition of the knee joint cavity with a 2.7 mm 30° arthroscope; the suspicious synocial tissues were extracted for pathological examination; by using a planer and a plasma radiofrequency ablation apparatus,the hyperplastic synovial tissue was removed. Results The operations were completed smoothly in all the 37 cases. The operation time was 30-60 min（ mean,45 min）. No complications such as vascular injury,nerve injury,or infection occurred. There were 32 cases chronic nonspecific synovitis,which was diagnosed as juvenile rhenmatoid arthritis. One of them was accompanied by destruction of articular cartilage and 17 patients were transferred to rheumatology department for medication.There were 2 cases of pigmented villonodular synovitis,2 cases of tuberculous synovitis（ transferred to tuberculosis hospital after operation）,and 1 case of meniscus injury. The hospitalization time was 3-7 d（ mean,5 d）. A total of 22 patients were followed up for 6 months-4 years（ mean,2. 3 years）. The results showed excellent in 11 cases,good in 7 cases,fair in 3 cases,and poor in 1 case,the excellent and good rate being 81. 8%（ 18/22）. Conclusion Arthroscopic diagnosis and treatment of children＇s single knee synovitis has satisfactory results.
作者
王宁青
邓京城
汪喜顺
任刚
杜宇
赖建明
Wang Ningqing, Deng Jingcheng, Wang Xishun, et al.(Department of Pediatric Orthopedics, Affiliated Children’s Hospital of Capital Institute of Pediatrics, Beijing 100020, Chin)
出处
《中国微创外科杂志》
CSCD
北大核心
2018年第7期632-635,共4页
Chinese Journal of Minimally Invasive Surgery
关键词
单膝关节滑膜炎
关节镜
小儿
Single knee synovitis
Athroscope
Children
