摘要
目的探讨全关节镜下治疗膝关节滑膜脂肪瘤病(synovial lipomatosis,SL)的临床疗效。方法回顾性分析2011年4月至2019年10月收治的20例膝关节SL患者资料,所有患者按随机双盲法分为治疗组和对照组,各10例。对照组常规治疗基础上给予塞来昔布胶囊口服治疗;治疗组在对照组基础上行关节镜下探查病灶滑膜切除术,比较两组患者治疗前和治疗4周、8周后膝关节肿胀、关节屈曲度、疼痛VAS评分及Lysholm评分。结果全部病例获得随访,随访期间治疗组有1例出现关节肿胀,治疗后症状消失,其余9例患者恢复良好。对照组2例患者膝关节肿痛和关节活动度改善明显,其余8例患者症状改善不明显;末次随访治疗组患者膝关节肿胀、关节屈曲度、VAS评分、Lysholm评分及有效率均优于对照组,差异有统计学意义。结论结合MRI和病理学检查,全镜下治疗膝关节SL具有确诊率高,创伤小,恢复快,疗效显著的优点,值得临床推广应用。
Objective To explore the clinical efficacy of arthroscopic treatment of Synovial lipomatosis(SL)of knee.MethodsData of 20 patients with knee SL admitted from April 2011 to October 2019 was retro-spectively analyzed.All patients were randomly divided into treatment group and control group by double-blindmethod,with 10 patients in each group.The control group was given celecoxib capsule oral treatment on the basisof routine treatment.In the treatment group,focal synoviectomy was explored under arthroscopy on the basis of thecontrol group,and the two groups were compared before and after treatment for 4 weeks,and after 8 weeks,kneeswelling,joint range of motion,VAS score and Lysholm score were compared.ResultsAll patients were followedup.During the follow-up period,1 patient in the treatment group developed joint swelling,and the symptoms disap-peared after treatment,while the remaining 9 patients recovered well.In the control group,2 patients showed sig-nificant improvement in knee joint pain and range of motion,while the remaining 8 patients showed no obvious im-provement in symptoms.Knee swelling,joint flexion,VAS score,Lysholm score and effective rate of the patientsin the last follow-up group were all better than those in the control group,and the differences were statistically sig-nificant.ConclusionsCombined with MRI and pathological examination,the total endoscopic treatment of kneejoint SL has the advantages of high diagnosis rate,small trauma,quick recovery and significant curative effect,which is worthy of clinical promotion and application.
作者
陈帅
宫大伟
康攀
吴智明
焦锋
王海彬
黄华扬
CHEN Shuai;GONG Dawei;KANG Pan;WU Zhiming;JIAO Feng;ZHANG Hongyi;WANG Haibin;HUANG Huayang(Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine,the Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510800,China;不详)
出处
《实用医学杂志》
CAS
北大核心
2020年第17期2399-2403,2408,共6页
The Journal of Practical Medicine
基金
国家自然基金面上项目(编号:81774339)
广州中医药大学2019年学科研究重大项目(编号:XK2019012)
广东省自然科学基金(编号:2020A1515011085)
广州市卫生健康委资助项目(编号:20191A011117)。
关键词
关节镜治疗
膝关节
滑膜脂肪瘤病
疗效
arthroscopic treatment
knee
synovial lipomatosis
curative effect
