全部 标题 作者
关键词 摘要

OALib Journal期刊
ISSN: 2333-9721
费用:99美元

查看量下载量

相关文章

更多...
华西医学  2015 

关节镜下滑膜切除术治疗膝关节类风湿关节炎的临床疗效观察

DOI: 10.7507/1002-0179.20150124, PP. 421-425

Keywords: 膝关节,类风湿关节炎,关节镜,滑膜切除

Full-Text   Cite this paper   Add to My Lib

Abstract:

目的 观察采用关节镜技术治疗膝关节类风湿关节炎(RA)的临床疗效。方法 2009年1月-2013年3月对31例RA患者(32膝)行滑膜切除。患者男10例,女21例;年龄23~51岁,平均(35.5±8.7)岁;患病时间5~21年,平均(12.0±5.5)年。观察患者术前、术后1年以及术后2年X线检查结果并用Larsen法进行评估。比较术前和术后1年C反应蛋白、红细胞沉降率(血沉)、膝关节疼痛评分的改变。结果 行关节镜下滑膜切除术后1年,膝关节疼痛评分从术前的(4.23±0.96)分下降至(2.21±0.87)分,类风湿因子从(265.3±120.1)U/mL下降至(89.2±12.1)U/mL,C反应蛋白从(89.36±32.12)mg/L降至(20.12±10.21)mg/L,血沉从(86.56±12.32)mm/h降至(45.23±11.12)mm/h,差异均有统计学意义(P<0.05)。X线Larsen评价术后1年有明显改善。结论 关节镜下行滑膜切除可缓解疼痛,阻止局部病变进展和改善关节周围骨质破坏。

References

[1]  1 Kirwan JR. The synovium in rheumatiod arthritia: evidence for (at least) two pathologies[J]. Arthritis Rheum, 2004, 50(1): 1-4.
[2]  2 Tarner IH, Harle P, Muller-Ladner U, et al. The different stages of synovitis: acute vs chronic, early vs late and non-erosive vs erosive[J]. Best Pract Res Clin Rheumatol, 2005, 19(1): 19-35.
[3]  3 曾润铭, 张忠民, 金大地. 类风湿关节炎滑膜细胞向破骨细胞分化实验研究[J]. 中华风湿病学杂志, 2005, 9(3): 149-153.
[4]  4 Arnett FC, Edworthy SM, Bloch DA, et al. The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3): 315-324.
[5]  5 Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films[J]. Acta Radiol Diagn (Stockh), 1977, 18(4): 481-491.
[6]  6 赵立恒, 余家阔, 罗浩. 膝关节十分区法及其在类风湿关节炎关节镜下滑膜全切除除术中的应用[J]. 中国微创外科杂志, 2009(4): 327-331.
[7]  7 van der Heijde D. Radiographic progression in rheumatoid arthritis: does it reflect outcome Does it reflect treatment [J]. Ann Rheum Dis, 2001, 60(Suppl 3): iii47-iii50.
[8]  8 Molenaar ET, Voskuyl AE, Dinant HJ, et al. Progression of radiologic damage in patients with rheumatoid arthritis in clinical remission[J]. Arthritis Rheum, 2004, 50(1): 36-42.
[9]  11 Nakamura H, Nagashima M, Ishigami S, et al. The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis[J]. Int Orthop, 2000, 24(5): 242-245.
[10]  12 Klug S, Wittmann G, Weseloh G. Arthroscopic synovectomy of the knee joint in early cases of rheumatoid arthritis: follow-up results of a multicenter study[J]. Arthroscopy, 2000, 16(3): 262-267.
[11]  13 Gibbons CE, Gosal HS, Bartlett J. Long-term results of arthroscopic synovectomy for seropositive rheumatoid arthritis: 6-16 year review[J]. Int Orhtop, 2002, 26(2): 98-100.
[12]  14 吕厚山, 孙炜, 寇伯龙, 等. 滑膜切除术治疗膝类风湿关节炎45例短期随访报告[J]. 中华骨科杂志, 1996, 16(1): 5-7.
[13]  15 Ossyssek B, Anders S, Grifka J, et al. Surgical synovectomy decreases density of sensory nerve fibers in synovial tissue of non-inflamed controls and rheumatoid arthritis patients[J]. J Orthop Res, 2011, 29(2): 297-302.
[14]  16 Chin KR, Barr SJ, Winalski C, et al. Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee[J]. J Bone Joint Surg Am, 2002, 84(12): 2192-2202.
[15]  17 Nakamura H, Tanaka H, Yoshino S. Long-term results of multiple synovectomy for patients with refractory rheumatoid arthritis. Effects on disease activity and radiological progression[J]. Clin Exp Rheumatol, 2004, 22(2): 151-157.
[16]  18 王湘达, 吕成昱, 王英振, 等. 膝关节复发性色素沉着绒毛结节性滑膜炎的关节镜治疗[J]. 中华骨科杂志, 2004, 24(3): 174-176.
[17]  9 Hitchon CA, El-Gabalawy HS. The synovium in rheumatoid arthritis[J]. Open Rheumatol J, 2001(5): 107-114.
[18]  10 Kubacki J, Kokosz M, Grygorowicz M, et al. The value of synovectomy of the knee in the treatment of rheumatoid arthritis[J]. Orthop Traumatol Rehabil, 2006, 8(1): 99-105.

Full-Text

Contact Us

service@oalib.com

QQ:3279437679

WhatsApp +8615387084133