18例手腕部腱鞘结核的诊治分析

目的：探讨原发性腱鞘结核在诊断和治疗上的经验教训，方法：1990年3月至2001年10月，对18例手腕部腱鞘结核患者采用手术，抗结核药物及功能锻炼等综合治疗后，分析其临床疗效，误诊原因和治疗要点。结果：18例患者的手部结核全部治愈，术后胡访6个月－11年，未见复发，15例功能恢复良好，3例因误用激素封闭病情加重，术后有一定的功能障碍，结论：腱鞘结核早期缺乏特异性诊断指标，需根据临床表现和实验室检查进行分析，及时作病灶清除术，加上系统的抗结核药物和功能锻炼等综合治疗，可以完全治愈。

Diagnosis and treatment of tuberculosis in synovial sheath in hand and wrist : an analysis of 18 cases

Objective To investigate experience on the diagnosis and treatment of primary tuberculosis in synovial sheath. Methods From March 1990 to October 2001, 18 cases of tuberculosis in synovial sheath at the wrist and hand were treated using surgery and antitubercular agents and rehabilitation. The outcomes, misdiagnosed reason and treatment points were analyzed respectively. Results All cases were cured. There was no recurrence after postoperative 6 to 11 months follow-up. Excellent function was obtained in 15 cases. There were 3 cases with somewhat disability because of injection of cortisone. Conclusions There was lack of specific index for early diagnosis. Diagnosis of primary tuberculosis in synovial sheath depends on the clinical manifestation and lab test. Healing could be achieved if focal cleaning,antitubercular medication and functional rehabilitation ware performed on time.