摘要
目的探讨肩关节色素沉着绒毛结节性滑膜炎（PVNS）合并肩袖损伤的诊断、治疗方法以及疗效。方法回顾分析2006年7月至2014年6月青岛大学附属医院收治的5例肩关节PVNS合并肩袖损伤患者临床资料，其中男性4例，女性1例；年龄24～43岁，平均（32±8）岁。发病至就诊时间最长为62月，最短1月，中位数为2月。采用统计软件SPSS20．0以Wileoxon符号秩检验对肩关节功能按照美国肩肘协会评分系统（ASES评分）、疼痛视觉模拟评分（VAS）进行评价。患者均于关节镜下行滑膜切除术，其中2例病程超过2年的患者未行肩袖修复术，其余3例行关节镜下肩袖修复术。结果本组患者术后切口均Ⅰ期愈合，5例均获随访，随访时间12～20个月。5例患者术后肩关节功能ASES评分为（76．6±14．1）分，明显高于治疗前，差异有统计学意义（Z=-2．032，P〈0．05）；术后VAS评分为（2．2±1．3）分，明显低于治疗前，差异有统计学意义（Z=-2．260，P〈0．05）。结论肩关节PVNS合并肩袖损伤的诊断较为困难，易漏诊和误诊，应引起重视；治疗时应在滑膜全切的基础上行肩袖修复术，可获满意疗效。
Objective To investigate the diagnosis and surgical procedures of the pigmented villonodular synovitis （PVNS） and rotator cuff tear. Methods Between July 2006 and June 2014, five patients with rotator cuff tear associated with pigmented villonodular synovitis were treated in the Affiliated Hospital of Qingdao University. There were four males and one female with a mean age of （ 32 ± 8 ） years （range, 24 -43 years）. The ＂onset to treatment＂ time was 62 months the longest and one month the shortest ; the median was two months. Shoulder joint function was evaluated according to American shoulder and elbow surgeons （ ASES ） scoring system and visual analogue scale （ VAS ） scoring. All the patients accepted arthroscopic resection of the synovial membrane. Two eases showed no rotator cuff repair forover two years, and the other three patients underwent arthroscopic rotator cuff repair. Results M1 the incisions healed by first intention without complication. All the five patients were followed up 12 to 20 months. ASES score of the five patients was （ 76. 6 ± 14. 1 ） and was significantly better than preoperative score （ Z = - 2. 032, P 〈 0.05 ）. The VAS score was （2. 2 ± 1.3 ） and was significantly better than preoperative score （ Z = - 2. 260, P 〈 0. 05 ）. Conclusion It is difficult to simultaneously diagnose lesions of the rotator cuff and pigmented villonodular synovitis; orthopedists should pay attention to possible patients to avoid missed diagnosis. Synovectomy and arthroscopic rotator cuff repair can achieve good effectiveness.
出处
《中华关节外科杂志（电子版）》
CAS
2016年第6期83-87,共5页
Chinese Journal of Joint Surgery(Electronic Edition)
