摘要
目的:探讨腕关节镜手术联合秋水仙碱治疗急性痛风性腕关节炎疗效。方法:将常规采用秋水仙碱+二黄新伤止痛软膏治疗的痛风性腕关节炎患者作为对照组(n=35),而经常规药物治疗关节活动度无明显改善或合并关节僵硬采用腕关节镜手术联合秋水仙碱治疗的痛风性腕关节炎急性发作患者作为观察组(n=35)。比较两组治疗前和治疗两周后疗效、外周血生化指标[细胞沉降率(ESR)、C-反应蛋白(CRP)、血尿酸(UA)]、Mayo腕关节评分及药物不良反应、手术并发症情况等。结果:观察组病程长于对照组(P<0.05),且两组患者关节功能分级分布不同(P<0.05)。治疗两周后,观察组的治疗总有效率高于对照组(85.72%vs.62.86%,P<0.05)。治疗后,两组ERS、CRP、UA随着时间呈逐渐降低趋势,组内各时间点比较差异均有统计学意义(P<0.05),观察组治疗后各时间点ERS、CRP、UA水平均低于对照组(P<0.05);治疗后,两组Mayo腕关节各维度评分随着时间呈逐渐升高趋势,组内各时间点比较差异均有统计学意义(P<0.05),观察组治疗后各时间点评分均高于对照组(P<0.05);两组治疗期间胃肠道不良反应发生率比较,差异无统计学意义(P>0.05);观察组术后1例患者出现关节血肿,术后并发症发生率为2.86%,两组对比差异无统计学意义(P>0.05);治疗6个月后,观察组的复发率低于对照组(0.00%vs.17.14%,P<0.05)。结论:腕关节镜手术联合秋水仙碱治疗急性痛风性腕关节炎疗效优于药物联合外治法,可有效预防复发,整体安全性较高。
Objective:To explore the efficacy of wrist arthroscopy supplemented with colchicine in the treatment of acute gouty wrist arthritis.Methods:Patients without significant improvement in range of motion after conventional drug therapy or with joint stiffness were treated with wrist arthroscopy supplemented with colchicine and enrolled as observation group(n=35),and patients with gout wrist arthritis who were routinely treated with colchicine+Erhuang Xinshang Zhitong ointment were included in control group(n=35).The effects of confounding factors such as gender and age were excluded by propensity score match,thus 35 pairs of patients were finally obtained.The efficacy,peripheral blood biochemical indicators[erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),blood uric acid(UA)],Mayo wrist score,adverse drug reactions and surgical complications were compared between the two groups before and 2 weeks after treatment.Results:The course of disease in observation group was longer than that in control group(P<0.05),and the distribution of joint function grading was different in the two groups(P<0.05).After 2 weeks of treatment,the total effective rate of treatment of 85.72% in observation group was significantly higher than 62.86% in control group(P<0.05).After treatment,the levels of ERS,CRP and UA in the two groups were gradually decreased with time,and there were statistically significant differences at different time points within the groups(P<0.05),and the levels of ERS,CRP and UA at each time point after treatment were significantly lower in observation group than those in control group(P<0.05).After treatment,the scores of dimensions of Mayo wrist joint of the two groups were gradually increased with time,and the differences at different time points within the groups were statistically significant(P<0.05),and the scores of observation group at each time point after treatment were significantly higher than those of control group(P<0.05).There were no statistical differences in the incidence rates of gastroin
作者
张静
程亚博
池昊天
ZHANG Jing;CHENG Ya-bo;CHI Hao-tian(Department of Wrists,Sichuan Orthopaedic Hospital,Chengdu 610041,Sichuan,China)
出处
《川北医学院学报》
CAS
2022年第4期451-455,共5页
Journal of North Sichuan Medical College
基金
2020年省干部保健科研课题(川干研2020-605)。
