CAJ | 학술논문

目的探讨手腕部痛风的诊断方法及治疗.方法对5例术前临床诊断为手腕部痛风的患者行病灶清除和神经、肌腱松解术,其中2例行痛风石切除.切除病变组织常规行病理检查.结果术后5例患者伤口均Ⅰ期愈合,无感染发生,术后平均随访时间为7个月.病理检查均证实为痛风性关节炎.2例伴有痛风石的患者,术后手指麻木症状好转,活动功能得到明显改善,但半年以后又有复发.3例患者腕部疼痛消除,腕关节活动及握力恢复接近正常,未再次复发.结论无明显痛风石形成的非典型手腕部痛风的患者,诊断较为困难,有效的治疗方法为手术探查,可早期明确诊断且术后疗效满意.而有明显痛风石形成的患者诊断容易,但术后疗效欠佳.
목적 탐토수완부통풍적진단방법급치료.방법 대5례술전림상진단위수완부통풍적환자행병조청제화신경、기건송해술,기중2례행통풍석절제.절제병변조직상규행병리검사.결과 술후5례환자상구균Ⅰ기유합,무감염발생,술후평균수방시간위7개월.병리검사균증실위통풍성관절염.2례반유통풍석적환자,술후수지마목증상호전,활동공능득도명현개선,단반년이후우유복발.3례환자완부동통소제,완관절활동급악력회복접근정상,미재차복발.결론 무명현통풍석형성적비전형수완부통풍적환자,진단교위곤난,유효적치료방법위수술탐사,가조기명학진단차술후료효만의.이유명현통풍석형성적환자진단용역,단술후료효흠가.
Objective To explore the diagnosis and treatment of gout in the hand and wrist. Methods Of the 5 cases of gout in the hand and wrist, 2 patients had tophus and underwent extirpating of the tophus, tenolysis and neurolysis. Another 3 patients without tophus underwent carpal tunnel release and localized debridement. All the resected tissues were subject to histological examination. Results Primary healing of the wound was achieved in all cases with no infection. The average postoperative follow-up period was 7 months.Histology confirmed the diagnosis of gouty arthritis. For the 2 patients with tophus, symptoms of finger numbness were alleviated and wrist function was significantly improved. There was, however, recurrence that demanded further treatment. For the 3 patients without tophus, their wrists were pain-free and the grip strength of their hands returned to near normal. Conclusion It is difficult to diagnose non-classic gout of the hand or wrist without tophus. Surgical exploration not only confirms the diagnosis of gout but more importantly is a definitive treatment. Diagnosis of gout with tophus is relatively easy, however surgical treatment leads to less ideal results.