色素沉着绒毛结节性滑膜炎的诊治

目的:总结28例色素沉着绒毛结节性滑膜炎(PVS)的治疗效果,并探讨其有效的诊断方法及治疗措施。方法:我科1990~2004年共治疗PVS患者28例,术前均行MRI和B超检查。14例病灶局限患者行关节镜下关节腔清理术;9例患者行滑膜广泛清扫术;5例骨质破坏患者在滑膜清扫基础上加病灶刮除植骨术。结果:术后随访1~12年,无手术并发症发生,2例患者术后复发再次手术后治愈,优良率达92.9%。结论:MRI和B超等手段可以早期诊断,有效提高治愈率;色素沉着绒毛结节性滑膜炎的预后与病程长短、病理类型及有无骨侵袭性密切相关。

Treatment of 28 Cases of Pigmented Villonodular Synovitis

Objective: To evaluate the therapy effect of 28 cases of pigmented villonodular synovitis (PVS), and to research the effective methods for diagnosis and treatment. Methods: MRI and ultrasonography were used to diagnose all of the 28 patients with PVS in our department from 1990 to 2004. Fourteen patients with limited PVS in knees were treated by synovectomy, 9 patients treated by total synovectomy, and 5 patients had to accept curettement and bone graft based on total synovectomy. Results: All the patients were followed up for 1-12 years postoperatively. No recurrence was found except two patients, who recurred after postoperatively and then reoperated. The rate of excellent effect of therapy was 92.9%. Conclusion: MRI and ultrasonography are helpful for the early diagnosis of PVS, and could increase the healing rate. The pathological classification and whether with bone infiltrations was closely related to the prognosis of PVS.