关节镜下滑膜切除术治疗类风湿腕关节炎

摘要

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.%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。