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[膝关节放射性滑膜切除术——相关经验]

[Radiosynovectomy of the knee--experience thereof].

作者信息

Miszczyk Leszek, Jochymek Bozena, Spindel Jerzy, Woźniak Grzegorz, Wygoda Zbigniew, Tukiendorf Andrzej

机构信息

Zaklad Radioterapii, Centrum Onkologii, Instytut im. Marii Skłodowskiej-Curie, Oddział w Gliwicach.

出版信息

Chir Narzadow Ruchu Ortop Pol. 2009 May-Jun;74(3):162-8.

Abstract

The aim of the study was the evaluation of 90Y radiosynovectomy performed in chronic exudative knee synovitis. The analyzed material comprised 81 90Y injections made between 2004 and 2008. The circumference of a knee, the volume of removed exudate, the knee mobility, the presence of pain, the temperature of a knee and the presence of floating patella (exudate) were evaluated. The percentage of pain-free patients increased from 12% to 50% after 1 year; an additional 10% of patients reported pain relief. The patient percentage with an increased knee temperature fell from 42% to 31% and the patients percentage with exudates decreased from 76% to 27. No improvement was found with respect to knee circumference. The knee mobility improvement (the patients percentage with full mobility) increased from 25% to 59% one month after the treatment) and exudate volume reduction was found only in the subgroup of patients suffering from pigmented villonodular synovitis. The obtained results permit the conclusion that 90Y radiosynovectomy for chronic exudative knee synovitis is an effective treatment modality; it relieves pain and reduces the patients percentage with exudate and increased knee temperature, and in the subgroup of patients suffering from the pigmented villonodular synovitis improves the knee mobility and reduces the volume of evacuated exudate.

摘要

本研究的目的是评估90钇放射性滑膜切除术治疗慢性渗出性膝关节滑膜炎的效果。分析的材料包括2004年至2008年间进行的81次90钇注射。评估了膝关节周长、抽出的渗出液量、膝关节活动度、疼痛情况、膝关节温度以及是否存在浮髌(渗出液)。无痛患者的比例在1年后从12%增至50%;另有10%的患者报告疼痛减轻。膝关节温度升高的患者比例从42%降至31%,有渗出液的患者比例从76%降至27%。膝关节周长方面未发现改善。治疗1个月后,膝关节活动度改善(完全活动的患者比例)从25%增至59%,且仅在色素沉着绒毛结节性滑膜炎患者亚组中发现渗出液量减少。所得结果表明,90钇放射性滑膜切除术治疗慢性渗出性膝关节滑膜炎是一种有效的治疗方式;它能缓解疼痛,降低有渗出液和膝关节温度升高的患者比例,并且在色素沉着绒毛结节性滑膜炎患者亚组中可改善膝关节活动度并减少抽出的渗出液量。

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