腘窝囊肿的诊断及治疗进展

腘窝囊肿是一种常见的膝关节周围囊肿，又叫Baker囊肿。随着目前对于腘窝囊肿的研究发现，其发病机制主要是由于各种原因引起的膝关节内压力增高，导致腓肠肌内侧头与半膜肌肌腱滑囊膨出而形成。目前的诊断方法主要有膝关节X线片、超声及MRI。其中，MRI被认为是诊断腘窝囊肿的金标准。治疗方法多种多样，主要有保守治疗、传统手术切除及关节镜手术。近年来，腘窝囊肿的治疗重点逐渐从单纯切除囊肿转变为关节镜下处理关节内病变及对关节腔与囊肿的交通口的处理上，并取得了不错的疗效，但对于最有效的治疗方式仍有争议，仍未确定最佳的手术方式。希望未来可以有高质量的前瞻性研究直接比较不同治疗方式的疗效，从而选择出最佳治疗方式。本文通过回顾过去的文献研究，分别从腘窝囊肿的流行病学、病理机制、临床表现与体征、辅助检查、诊断与鉴别诊断及临床治疗6个方面详细描述。对不同诊断方法及治疗方法进行对比总结，为临床诊疗提供依据。

Diagnosis and therapy of popliteal cyst

Popliteal cyst is a common peri-knee cyst, also known as a Baker''s cyst. With the current development of popliteal cysts, the pathogenesis is mainly due to increased pressure in the knee joint caused by various reasons, leading to a fluid-filled sac that can form behind the knee as a result of enlargement of the gastrocnemius-semimembranosus bursa. The current diagnostic methods include X-ray computed, ultrasound, and magnetic resonance. Among them, magnetic resonance imaging is considered the gold standard for the diagnosis of popliteal cysts. There are various treatments, including conservative treatment, traditional surgical resection and arthroscopic surgery. In recent years, the focus of the treatment of popliteal cysts has gradually shifted from the simple removal of cysts to arthroscopic treatment of intra-articular lesions and the treatment of joint-cyst communication, and achieved a good effect. However, there are still controversies about the most effective treatment, and the best surgery method is still uncertained. It is hoped that high quality prospective studies will be able to directly compare different surgery methods, so as to select the best treatment for popliteal cyst. This article reviews past literature research and describes in detail the epidemiology, pathological mechanism, clinical manifestations and signs, auxiliary examination, diagnosis and differential diagnosis and clinical treatment of popliteal cysts. Different diagnosis methods and treatment methods are compared and summarized to provide basis for clinical diagnosis and treatment.