天津医药

• 临床论丛 •    

16例手部腱鞘结核诊疗体会

王力1,张文龙2,高巍1,邱南海3   

  1. 1. 天津市海河医院
    2. 海河医院
    3. 天津海河医院
  • 收稿日期:2011-03-21 修回日期:2011-09-06 出版日期:2012-01-15 发布日期:2012-01-15
  • 通讯作者: 王力

  • Received:2011-03-21 Revised:2011-09-06 Published:2012-01-15 Online:2012-01-15

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摘要： 目的：探讨手部腱鞘结核的诊断治疗的经验体会。方法：2003年6月~2010年10月，对本院诊治的16例手部腱鞘结核患者，通过抗结核药物、手术及功能恢复训练治疗，分析发病原因、临床治疗要点及复发原因。结果：术后随访6~24月，15例手部结核伤口愈合良好，1例术后1月复发经二次手术后治愈。14例病例患指功能功能明显改善，2例因病程较长功能障碍改善不明显。结论：手部腱鞘结核延迟诊断及误诊较高，因缺乏特异性指标，需整体把握病史查体及辅助检查结果做出判断。选择恰当手术时机及方式，系统规范抗结核用药及术后恢复训练，大多可以得到满意效果。

关键词: 腱鞘结核, 显微外科手术, 抗结核治疗

Abstract: Objective: To investigate the experience of diagnosis and treatment of tuberculous tenosynovitis in hand. Methods: June 2003 ~ October 2010, 16 cases of hospital treatment of tuberculous tenosynovitis in hand, by carrying on anti-TB drugs, surgical treatment and functional recovery training, analyze etiology, differential diagnosis, clinical treatment keypoints and Recurrence. Results: The patients were followed up 6 to 24 months, 15 cases of tuberculous tenosynovitis healed well, and 1 case relapse 1 month later after surgery that were cured by the second operation, not recurring again. 14 cases were obviously improved than before, 2 cases are still associated with some dysfunction. Conclusion: As to tuberculous tenosynovitis ,there is a high rate of Delayed diagnosis and misdiagnosis.while lacking of specific indicators, we need to grasp the whole history of physical examination and ancillary test results to make judgments. Note that choosing the appropriate time and method of operation, the systematic anti-tuberculosis drugs curement and postoperative recovery training, most of them can be satisfied with the results.

Key words: tuberculous tenosynovitis, Microsurgery, anti-TB treatment