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目的探讨类风湿关节炎致自发性手指肌腱断裂的临床特点和治疗效果。方法对8例自发性手指肌腱断裂的患者(均有3～8年类风湿关节炎的病史),其中2例拇长伸肌腱断裂,采用示指固有伸肌腱转位修复;3例环、小指指伸肌腱断裂,采用环指指伸肌腱与中指指伸肌腱端侧编织缝合,示指固有伸肌腱移位修复小指固有伸肌腱;2例中、环、小指指伸肌腱断裂,采用冷冻异体指伸肌腱移植修复。1例拇长屈肌腱断裂,采用环指指浅屈肌腱转位修复。结果术后局部滑膜和肌腱组织送病理检查均显示为慢性炎症伴局灶性坏死。术后随访6个月～7年,未见肌腱再次断裂,优良率为100%。结论多根肌腱同时断裂是类风湿关节炎致自发性手指肌腱断裂的常见特点,手术采用肌腱转位或异体肌腱移植术,疗效确切。
Objective To investigate the clinical features and treatment of spontaneous finger tendon rupture caused by rheumatoid arthritis. Methods Eight cases of patients with spontaneous rupture of finger tendon (all had a history of 3 ~ 8 years of rheumatoid arthritis), including 2 cases of rupture of thumb extensor tendon, Extensor tendon rupture, the use of ring finger extensor tendon and the middle finger extensor tendon end of the side of the knitting suture, showing the intrinsic extensor tendon shift repair native small finger extensor tendon; 2 cases, the ring, the little finger extensor tendon rupture, Transplant repair. A case of thumb flexor tendon rupture, ring finger flexor tendon transposition repair. Results Postoperative local synovial membrane and tendon tissue were sent for pathological examination showed chronic inflammation with focal necrosis. After 6 months to 7 years follow-up, no tendon rupture again, excellent and good rate was 100%. Conclusions Simultaneous rupture of multiple tendons is a common feature of spontaneous rupture of finger tendon induced by rheumatoid arthritis. The operation of tendon transposition or allogeneic tendon grafting is effective.