摘要
目的:探讨总结中青年四肢痛风石患者手术治疗疗效和治疗体会。方法:选取自2015年8月至2021年3月行手术治疗的50例四肢痛风石患者,均为男性,年龄为30~55岁,平均为40岁。术前均积极内科会诊治疗。术中根据痛风石侵蚀程度选择不同的术式,全部一期完成。术后随访,评估患者创口愈合情况,患肢外观,关节活动度及稳定性,视觉模拟量表(VAS)评分及有无原位复发。结果:50例患者中4例切口延期愈合,46例切口一期愈合(2~3周拆除缝线)。46例患者获得完整随访,随访时间为6个月至6.5年,患者四肢畸形得到矫正,外形包块消失,受累关节活动度明显改善(关节融合除外),稳定性可靠,VAS评分下降,手术原部位均无痛风石复发,整体治疗效果满意。结论:积极适时的手术切除痛风石是恢复患者外形及功能,阻止痛风性关节炎进一步加重,降低机体尿酸负荷的有效方法。特别对中青年患者,在条件允许的情况下尽最大可能保留和修复原有解剖结构,争取一期完成手术,大大减轻患者的身体痛苦及经济负担,从而提高患者生活质量。
Objective:To discuss and summarize the surgical methods and treatment experience of patients with tophi of limbs,especially young and middle-aged patients.Methods:From August 2015 to March 2021,50 male patients,aged from 30 to 55 years old with 40 years old on average,suffering extremity tophi who underwent surgical treatment were selected.All patients received active medical consultation and treatment before surgery.Different surgical methods were selected according to the degree of tophi erosion during the operation,and all of them were completed in one stage.During postoperative follow-up,the wound healing,appearance of the affected limb,range of motion,stability,visual analogue scale(VAS)score and in situ recurrence were evaluated.Results:Among the 50 patients,4 patients had delayed incision healing,and 46 patients had primary incision healing(2 to 3 weeks after removal of sutures).A total of 46 patients in this group were followed up for 6 months to 6.5 years.The deformity of the limbs of the patients was corrected,and the external mass disappeared.The range of motion of the involved joints was significantly improved(except for joint fusion),the stability was reliable,the VAS score was decreased.There was no recurrence of tophi in the original surgical site.The overall treatment efficacy was satisfactory.Conclusion:Active and timely surgical removal of tophi is an effective method to restore the patient's appearance and function,prevent the further aggravation of gouty arthritis,and reduce the body's uric acid load.Especially for young and middle-aged patients,we should try our best to preserve and repair the original anatomical structure if conditions permit,and strive to complete the operation in one stage,greatly reducing the physical and economic burden of patients,and thus improving the quality of life of patients.
作者
张宪男
顾宇
张樑
单臣
ZHANG Xiannan;GU Yu;ZHANG Liang;SHAN Chen(Department of Hand-Foot Surgery,Jilin Province People's Hospital,Changchun 130021,China;Department of Pathology,China-Japan Union Hospital of Jilin University,Changchun 130033,China.)
出处
《中国中医骨伤科杂志》
CAS
2023年第4期76-79,共4页
Chinese Journal of Traditional Medical Traumatology & Orthopedics
关键词
痛风石
手术治疗
四肢
中青年患者
tophi
surgery
limbs
young and middle-aged patients
