盲式细针滑膜活检术的临床观察

目的 探讨盲式细针滑膜活检的最佳方法.方法 81例膝关节肿痛患者行盲式细针滑膜活检,其中20例类风湿关节炎(RA)患者术前超卢定位. 结果 所有患者均成功取出合格滑膜,活检成功率为(71±21)%,操作时间为(26±6)min,套针进针深度为(3.1±0.7)cm,合格滑膜面积为(1.8±0.8)mm2.其中RA患者活检成功率(80±6)%明显高于非RA患者(54±10)%,超声定位的活检成功率(85±5)%明显高于未经超声定位者(78±6)%.肉眼判断滑膜组织的阳件预测值为95.0%,阴性预测值为81.1%. 结论 盲式细针滑膜活检成功率高、安全,能获取足够滑膜,值得临床推广应用.

Clinical observation of blind needle synovial biopsy

Objective To investigate the optimal technology of blind needle synovial biopsy.Methotis Blind needle synovial biopsy was performed on 81 knees with pain and swelling.Twenty patients with rheumatoid arthritis (RA) received uhrasonographic (US) examination before biopsies.Results Synovium were obtained in all patients and the successful rate was (71±21)%,while the area of synovium was (1.8±0.8)mm2.The time for accomplishing the procedure was (26±6) min and the depth of trocar insertion Was (3.1±0.7) cm.The successful rate in patients with RA (80±6)% was much higher than that in non-RA patients (54±10)%.The successful rate with US guidance (85±5)% was much higher than that without US guidance (78±6)%.The positive predictive value of synovium evaluation by naked eye Was 95.0%,while the negative predictive value was 81.1%.Conclusion Blind needle synovial biopsy should be spread because it is simple and safe to perfonn and it can obtain sufficient synovium for all purposes.