关节镜下诊断与治疗膝关节滑膜炎的探讨

目的：探讨膝关节滑膜炎在关节镜下的诊断与疗效。方法：自2000年1月～2003年10月，我院对49例病因不明，保守治疗无效的膝关节滑膜炎进行关节镜检查及镜下滑膜切除术。结果：镜检结合滑膜病理和各项实验室检查，进一步明确诊断的病例为：24例诊断为类风湿性关节炎，11例慢性非特异性滑膜炎，10例色素沉着绒毛结节性滑膜炎，2例关节结核，2例慢性化脓性关节炎。滑膜切除术后随访6～40个月，平均随访18个月。疗效优者29例(59．2％)，良15例(30．6％)，可3例(6．1％)，差2例(4％)。结论：关节镜检查及滑膜活检可明显提高滑膜炎的病因诊断率，关节镜下滑膜切除术对多种滑膜炎有效，创伤小，并发症很少，应为滑膜炎经保守治疗无效者较为理想的外科治疗方法。

The Diagnosis and Treatment of Gonarthromening Itis by Arthroscope

Objective:To evaluate the diagnosis and treatment of gonarthromeningitis by arthroscope.Methods:From January 2000 to October 2003,arthroscopy and synovectomy with arthroscope were performed in 49 patients with gonar thromening itis in which conservative treatment was ineffective.Results:24 patients with rheumatoid arthritis,11 Chronic non-specific synovitis,10 pigmented villonodular synovitis,2 tuberculosis of joint and 2 chronic pyogenic arthritis were diagnosed according to arthroscopy,pathologic and laboratory finding.Duration of follow-up after synovectomy was 18 months (range,6 months to 40 months).The therapeutic efficacy was excellent in 29 cases (59.2%),better in 15 (30.6%),moderate in 3 (6.1%) and worse in 2 (4%).Conclusion:The arthroscopy can improve the rate of etiologic diagnosis of synovitis.Synovectomy with arthroscope is an effective surgical approach with mini-trauma and less complications for treatment of cartain synovitis.