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目的研究膝关节滑膜源性肿瘤的临床特征,探讨并分析滑膜肿瘤的临床表现并提出鉴别诊断及治疗方法。方法回顾我院从2005年至2009年收治的38例经病理证实为膝关节滑膜源性肿瘤患者的诊断、治疗及随访观察,分析各类型滑膜肿瘤病变的临床表现、影像学的特点及手术方法,并观察各类型滑膜病变的不同病理特征。结果膝关节滑膜源性肿瘤好发于各个年龄段,38例患者包括色素沉着绒毛结节性滑膜炎,滑膜软骨瘤病,滑膜血管瘤,滑膜肉瘤,滑膜脂肪瘤,术后得到随访的31例患者中(平均随访时间28.4个月),色素沉着绒毛结节性滑膜炎复发4例(22%),滑膜软骨瘤病1例(17%),滑膜肉瘤1例(50%),膝关节功能总体优良率为83.9%。结论膝关节滑膜源性肿瘤病种复杂,易误诊误治,应通过详细地询问病史,仔细对患者做体格检查,配合实验室及影像学检查,采用切开直视的手术方法减少误诊率并提高治疗效果。
Objective To study the clinical features of synovial-derived tumors in the knee joint, to explore and analyze the clinical manifestations of synovial tumors and to propose the differential diagnosis and treatment methods. Methods The diagnosis, treatment and follow-up of 38 patients with pathologically confirmed synovial tumor of knee joint admitted from 2005 to 2009 in our hospital were retrospectively analyzed. The clinical manifestations and imaging features of various types of synovial tumor were analyzed. Surgical methods, and observe the different pathological features of various types of synovial lesions. Results Knee synovial-derived tumors occurred in all age groups. Thirty-eight patients included pigmented villonodular synovitis, synovial chondromatosis, synovial hemangioma, synovial sarcoma, synovioma, Among the 31 patients who were followed up (mean follow-up time was 28.4 months), 4 (22%) patients had pigmented villonodular synovitis, 1 had synovial chondromatosis (17%), 1 had synovial sarcoma Cases (50%), the overall excellent knee joint function rate was 83.9%. Conclusions The synovial-derived tumors in the knee joint are complicated and easily misdiagnosed and mistakenly treated. Physical examination should be carefully conducted on patients with detailed medical history. Laboratory and radiological examinations should be performed carefully to reduce the misdiagnosis rate And improve the treatment effect.