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目的探讨关节镜下膝关节结核性滑膜炎的特点及关节镜对该病的诊疗效果。方法 2005年6月至2008年3月郑州大学第一附属医院骨科应用关节镜对26例膝关节结核性滑膜炎病人行诊疗,术后配合关节腔注射链霉素、异烟肼,全身抗结核药物治疗。手术前后对病人行可视痛觉评分(VAS)测定。结果病人术后疼痛明显减轻,随访4个月至3年,无手术并发症发生,病人恢复良好。按Lysholm功能评分标准评定:疗效满意23例(88.5%);不满意2例(7.8%);差1例(3.8%),再次行关节镜手术效果满意。结论关节镜下行膝关节结核性滑膜清理,具有创伤性小、清除彻底、并发症少、复发率低等优点,配合局部及全身抗结核药物治疗可明显控制病情发展,提高疗效,改善关节功能。
Objective To investigate the characteristics of arthroscopic tuberculous synovitis and the effect of arthroscopy on the diagnosis and treatment of this disease. Methods From June 2005 to March 2008, 26 cases of tuberculous synovitis of knee joint were treated by arthroscopy in the orthopedics department of the First Affiliated Hospital of Zhengzhou University. Combined with intra-articular injection of streptomycin, isoniazid, Tuberculosis drug treatment. Visual acuity score (VAS) was measured before and after surgery. Results The patient’s postoperative pain was significantly reduced, followed up for 4 months to 3 years, no operative complications, the patient recovered well. According to Lysholm functional score, 23 cases (88.5%) were satisfied with the curative effect, 2 (7.8%) were unsatisfied, and 1 case (3.8%) were unsatisfactory. The arthroscopic operation was satisfactory again. Conclusions Arthroscopic knee synovial dissection with traumatic, complete removal, fewer complications, low recurrence rate, combined with local and systemic anti-TB drug therapy can significantly control the progression of the disease, improve efficacy and improve joint function .