Namba H
Nihon Seikeigeka Gakkai Zasshi. 1981 Jun;55(6):527-41.
In the preoperative state, there were similar local findings on both sides of the wrist joint involved by rheumatoid arthritis in the roentgenogram. Synovectomy was performed on the one side of the wrist joint. Thirty six cases were compared with untreated controls and evaluated annually for eight years. From the roentgenological point of view, both wrists have almost similarly taken a turn for the worse. In spite of synovectomy, prevention of joint destruction has been unsuccessful. In the operated wrists it was due to ROM and pronation-supination which significantly improved wrist joint function. Although this improved level has been favorably maintained, there was a decline in dorsipalmar flexion and radio-ulnar flexion year after year. The results in the operated wrists were adequately better than the untreated wrists. Relief of pain was reported as follows: 94.4% : 2 years after the operation 84.8% : 4 years 81.3% : 6 years 80.0% : 8 years Synovectomy was followed by significantly less pain and satisfaction of treatment as reported by most patients. However analgetic effects of early synovectomy that was performed was ineffective and prevention of the destruction of joints roentgenologically met with negative results. The validity and the permanency of this synovectomy study was proved by the comparative evaluations made between the treated wrist joints and the untreated wrist joints, and also by the established clinical results.
在术前状态下,类风湿关节炎累及的腕关节两侧在X线片上有相似的局部表现。对一侧腕关节进行了滑膜切除术。将36例患者与未治疗的对照组进行比较,并进行了为期八年的年度评估。从放射学角度来看,两侧手腕的情况几乎同样恶化。尽管进行了滑膜切除术,但预防关节破坏并未成功。在接受手术的手腕中,这是由于关节活动度(ROM)和旋前-旋后功能显著改善了腕关节功能。虽然这一改善水平得到了较好的维持,但掌背屈和桡尺屈功能年复一年地下降。接受手术的手腕的结果明显优于未治疗的手腕。疼痛缓解情况如下:术后2年为94.4%,4年为84.8%,6年为81.3%,8年为80.0%。大多数患者报告滑膜切除术后疼痛明显减轻,治疗满意度较高。然而,早期进行的滑膜切除术的镇痛效果不佳,在放射学上预防关节破坏的结果也不理想。通过对治疗的腕关节和未治疗的腕关节进行比较评估以及已确立的临床结果,证明了这项滑膜切除术研究的有效性和持久性。