| Objective: To explore the clinical effect of tuberculous tenosynovitis of wrist under operation combined with drugs.Methods: 26 cases of tuberculous tenosynovitis of the wrist were treated by operation in our hospital in the past 5 years.The time of wound healing,ESR,CRP,VAS,Jebsen hand function score before and after operation,Michigan University hand function score,recurrence rate and postoperative complications were analyzed.IBM SPSS 24 statistical software is used for data statistics.Results: 24 of 26 patients were followed up with 92.3%.Among the 26 patients,25 patients had stage I healing,accounting for 96.2%,and the average time of wound healing was 11.42 ± 2.10 days;In this group,ESR 22.97 ± 13.44mm/H before operation,41.29 ± 9.62mm/H one week after operation,and ESR returned to normal three months after operation.CRP of the patients was 42.03 ±5.47mg/L before operation,and decreased significantly 1 month after operation.After 3 months,it decreased to normal.The changes of ESR and CRP were statistically significant(P < 0.001).After operation,the patients’ pain was improved.The scores of VAS,1 month,3 month and6 month were 7.96 ± 1.30,3.79 ± 1.64,2.38 ± 1.35 and 2.04 ± 1.30,respectively.The difference between the groups was statistically significant(F = 101.26,P < 0.001).The hand function of the patients was improved objectively and subjectively.Jebsen’s hand function scores were 46.16 ± 2.84 seconds,34.45 ± 2.76 seconds,29.41 ± 1.51 seconds,and 25.90 ± 1.50 seconds before,1 month,3 months,and 6 months after the operation,respectively.The difference between the groups was statistically significant(F = 304.62,P < 0.001).The Michigan evaluation was quantified as 0-100 points,65.33 ± 3.21 points,84.71 ± 2.33 points,92.71 ± 4.33 points and 93.71 ± 3.46 points before operation,1 month after operation,3 months and 6 months after operation,respectively.There was significant difference in MHQ scores before operation,1month after operation and 3 months after operation(F = 307.61,P <0.001).There was no difference in MHQ score between 6 months and 3months after operation(P = 0.41),and there was difference in MHQ score between 6 months before operation and 1 month after operation(P <0.001).During the follow-up period,2 patients recurred,the recurrence rate was 7.6%.Transaminase increased in 5 cases(19.2%).There were no adverse reactions of jaundice,peripheral neuritis and blurred vision during the follow-up.Conclusion: On the basis of antituberculous treatment of tuberculous tenosynovitis,surgical treatment has good effect and low recurrence rate,which can improve the symptoms and limb function of patients in early stage. |
