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目的对11例成人膝关节内腱鞘巨细胞瘤(giant cell tumor of tendon sheath,GCTS)病例进行回顾分析,探讨膝关节内GCTS的临床特点及关节镜治疗体会。方法回顾性分析自2005年4月至2014年7月收治的11例成人膝关节GCTS患者,男6例,女5例,年龄18~49岁,平均36.3岁,左膝4例,右膝7例。所有病例均采用关节镜下手术治疗。随访术后膝关节功能恢复情况,采用改良HSS评分进行膝关节功能评定。结果术后11例均获12~48个月的门诊随访,平均30.1个月。术后8周时,所有患者症状明显改善或消失,较术前关节功能明显改善,HSS评分:术前(33±5.1)分,术后8周(93±3.7)分,差异有高度统计学意义(P<0.01);术后6个月(93±3.9)分;术后1年(94±2.8)分;术后2年(94±2.5)分;术后4年(95±1.6)分,与术后8周时比较,差异均无统计学意义(P>0.05)。所有患者至末次复诊均未见复发。结论膝关节内GCTS极易漏诊误诊,术前通过仔细查体,并结合核磁共振、彩超检查,显著提高膝关节内GCTS的诊断准确率。关节镜下彻底切除是治疗本病的有效治疗手段。
Objective To retrospectively analyze the clinical features of giant cell tumor of tendon sheath (GCTS) in 11 adult patients with knee joint and to explore the clinical features of the knee joint with GCTS and the experience of arthroscopic treatment. Methods The clinical data of 11 adult patients with GCTS from April 2005 to July 2014 were retrospectively analyzed. There were 6 males and 5 females, aged from 18 to 49 years, with an average of 36.3 years old. There were 4 left knees and 7 right knees example. All cases were treated with arthroscopic surgery. Follow-up postoperative knee functional recovery, the use of improved HSS score knee function assessment. Results All the 11 cases were followed up for 12 to 48 months with an average of 30.1 months. At 8 weeks after operation, the symptoms of all patients improved or disappeared significantly, which was significantly improved compared with that before operation. The HSS score was 33 ± 5.1 before surgery and 93 ± 3.7 after 8 weeks. The difference was statistically significant (94 ± 2.8) at 2 months after surgery (94 ± 2.5); after 4 years (95 ± 1.6) at 4 years after operation Points, compared with 8 weeks after operation, the difference was not statistically significant (P> 0.05). All patients to the last referral no recurrence. Conclusions GCTS can easily misdiagnose and misdiagnose in knee joint. Before operation, it can improve the diagnostic accuracy of GCTS in knee joint by carefully examining the body and combining with MRI and color Doppler ultrasound examination. Arthroscopic radical resection is an effective treatment for the disease.