抗结核化疗联合关节成形术或关节置换术治疗肘关节结核的疗效分析:40 例患者的回顾性研究。

Qi Tian,Haopeng Luan,Xufeng Guo,Kai Liu,Cong Peng,Bin Du
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摘要

肘关节结核性关节炎(TAEJ)是一种较为罕见的传染性骨关节疾病。由于早期症状不明显而被误诊,往往在治疗时肘关节已遭受严重损伤。本研究对肘关节结核(TB)的临床表现、人群特征、临床诊断、手术治疗和功能恢复进行了回顾性研究。本研究对 40 名患者进行了回顾性研究。这些患者于2007年6月至2021年8月期间被诊断为肘关节结核性关节炎,并通过细针穿刺活检或手术切除病灶的活检确诊为肘关节结核。所有患者均在服用常规抗结核药物和化疗 2 周后接受手术治疗。采用视觉模拟评分、梅奥肘关节表现评分和特殊外科医院评估量表评分来评估术后功能恢复情况。影像学检查用于评估患者的术后恢复情况。对 40 名患者进行了平均为 12.5 ±0.5 个月的随访。经过抗结核药物化疗和手术切除感染病灶组织后,红细胞沉降率和C反应蛋白值恢复正常;只有一名患者在术后16个月复发。肘关节结核性关节炎应根据临床表现、实验室检查和组织病理学检查进行早期诊断。在使用抗结核药物化疗 2 周后,应通过手术彻底切除病灶。应根据肘关节的损伤情况选择相应的手术方式。
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Efficacy Analysis of Anti-Tuberculosis Chemotherapy Combined with Arthroplasty or Joint Replacement for Tuberculous of the Elbow Joint: A Retrospective Study of 40 Patients.
Tuberculous arthritis of the elbow joint (TAEJ) is a relatively rare infectious bone and joint disease. Misdiagnosed owing to inconspicuous early symptoms, often the elbow joint has suffered serious damage at the time of treatment. This study retrospectively investigated the clinical manifestations, population characteristics, clinical diagnosis, surgical treatment, and functional recovery of elbow joint tuberculosis (TB). A retrospective study of 40 patients was conducted. These patients were diagnosed with tuberculous arthritis of the elbow from June 2007 to August 2021 and were diagnosed with TAEJ by fine-needle aspiration biopsy or biopsy of surgically excised lesions. All patients underwent surgery after taking regular anti-TB drugs and chemotherapy for 2 weeks. Visual analogue scale score, Mayo elbow performance score, and hospital for special surgery assessment scale score were used to evaluate postoperative functional recovery. Imaging tests were used to evaluate patients' postoperative recovery. Forty patients were followed up for an average of 12.5 ±0.5 months. Erythrocyte sedimentation rate and C-reactive protein values returned to normal after anti-TB drug chemotherapy combined with surgical removal of infected lesion tissue; only one patient relapsed 16 months after surgery. Tuberculous arthritis of the elbow joint should be diagnosed in an early stage based on clinical manifestations, laboratory tests, and histopathological examinations. Complete surgical removal of the lesions should be performed after chemotherapy with anti-TB drugs for 2 weeks. The corresponding operation should be selected according to the damage in the elbow joint.
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