摘要
目的总结类风湿腕关节炎行关节镜下滑膜切除术的疗效。方法对35例类风湿腕关节炎患者行关节镜下滑膜切除术治疗。术前1周及术后1年采用VAS评分对腕关节疼痛进行评价,测量患者腕关节屈伸活动度,检测患者类风湿因子(RF)、C-反应蛋白(CRP)、红细胞沉降率(ESR)水平。结果患者均获得随访,时间12~20个月。VAS评分术前(8.5±2.7)分,术后1年(3.5±1.3)分;腕关节屈伸活动度术前77.0°±17.0°,术后1年117.0°±19.0°;RF术前(58.1±12.2)U/ml,术后1年(23.1±8.6)U/ml;CRP术前(31.3±4.0)mg/L,术后1年(13.1±3.0)mg/L;ESR术前(52.4±4.5)mm/1h,术后1年(22.5±3.6)mm/1h。术后1年各项指标与术前比较差异均有统计学意义(P<0.01)。术后1年疗效评价:优15例,良11例,可7例,差2例,优良率74.29%。结论类风湿腕关节炎患者实施关节镜下滑膜切除术治疗,可减轻患者疼痛,提升关节活动度,效果显著。
Objective To summarize the clinical effect of arthroscopy synovectomy in the treatment of rheumatoid ar-thritis of the wrist. Methods Thirty-five patients with rheumatoid arthritis of the wrist were treated by arthroscopy synovectomy. The pain of wrist before and 1 year after surgery were evaluated by visual analogue scale （VAS） , and the wrist flexion and extension of patients were measured. The rheumatoid factor （ RF） , C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR） level of patients were detected. Results The VAS was 8. 5 ± 2. 7 before sur-gery and 3. 5 ± 1. 3 after surgery. The wrist flexion and extension was 77. 0° ± 17. 0° before surgery and 117. 0° ± 19. 0°after surgery. The RF was （58. 1 ± 12. 2）U/ml before surgery and （23. 1 ±8. 6）U/ml after surgery. The CRP was （ 31. 3 ±4. 0） mg/L before surgery and （13. 1 ±3.0） mg/L after surgery. The ESR was （ 52. 4 ± 4. 5 ） mm/1 h before surgery and （22. 5 ± 3. 6） mm/1 h after surgery. There were statistically significant differences between the postoperative and preoperative indexes （P 〈0. 01）. Patients with excellent, good, fair, and poor postoperative effi-cacy were 15 cases, 11 cases, 7 cases and 2 cases respectively. The excellent and good rate was 74. 29%. Conclu-sions Applying arthroscopic synovectomy treatment for patients with rheumatoid arthritis of the wrist can reduce pain and improve joint mobility, and the effect is significant.
出处
《临床骨科杂志》
2017年第1期54-55,57,共3页
Journal of Clinical Orthopaedics
