CAJ | 학술논문

目的：探讨关节镜在治疗反复发作性痛风性膝关节炎中的应用价值，并探讨和观察运用关节镜下清理术联合术后置管持续引流治疗痛风性关节炎的方法和疗效。方法17例膝关节痛风性关节炎患者，行关节镜下清理及滑膜切除术，术后灌洗并常规服用降血尿酸药物、早期功能锻炼。比较患者术前和术后6个月的膝关节Lysholm评分。结果痛风性关节炎的关节镜表现为特异性的白色团块状物质沉积在滑膜、软骨和其他关节内结构的表面。所有患者均获得6～24个月的随访，平均随访16．3个月，术后末次随访时无明显复发的病例。根据Lysholm的膝关节评分，术前患者功能评分（50．0±3．1）分；术后6个月评分（90．0±2．8）分；2次评分差异有统计学意义（P＜0．01）。结论关节镜对痛风性关节炎的诊断准确率高，关节镜下关节清理及滑膜切除术配合术后灌洗是治疗痛风性关节炎的一种见效快、创伤小、效果确切的微创治疗方法。
목적：탐토관절경재치료반복발작성통풍성슬관절염중적응용개치，병탐토화관찰운용관절경하청리술연합술후치관지속인류치료통풍성관절염적방법화료효。방법17례슬관절통풍성관절염환자，행관절경하청리급활막절제술，술후관세병상규복용강혈뇨산약물、조기공능단련。비교환자술전화술후6개월적슬관절Lysholm평분。결과통풍성관절염적관절경표현위특이성적백색단괴상물질침적재활막、연골화기타관절내결구적표면。소유환자균획득6～24개월적수방，평균수방16．3개월，술후말차수방시무명현복발적병례。근거Lysholm적슬관절평분，술전환자공능평분（50．0±3．1）분；술후6개월평분（90．0±2．8）분；2차평분차이유통계학의의（P＜0．01）。결론관절경대통풍성관절염적진단준학솔고，관절경하관절청리급활막절제술배합술후관세시치료통풍성관절염적일충견효쾌、창상소、효과학절적미창치료방법。
Objective To study the therapeutic effects of the debridement combined with continuous drainage after surgery in the treatment of joint gouty arthritis under arthroscopy and also to explore the value of arthroscopy in the treatment of recurrent gouty ar -thritis of the knee .Methods There were 17 patients with joint gouty arthritis who received joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage .After surgery, the patients were given routine drug therapy and early func-tional exercise .Lysholm scores of the knee were compared before surgery and 6 months after surgery .Results Gouty arthritis under ar-throscopy displayed specific white ball -like crystal deposited on the surfaces of synovium , cartilage and other joint structure .All the patients had medical follow -ups for a duration of 6 to 24 months, averaging 16.3 months.Last follow-up revealed that there was not a significant recurrent case after surgery .In accordance with the Lysholm knee scores , the patient function scores before surgery were (50.0 ±3.1), and the function scores 6 months after surgery were (90.0 ±4.8) on the average.Significant statistical differences could be noted in Lysholm scores, when comparisons were made before surgery and 6 months after surgery (P<0.01).Conclusion Arthroscopy displayed a high diagnostic rate of gouty arthritis , at the same time , joint debridement and synovectomy under arthroscopy combined with lavage and continuous drainage were a good treatment method with quick response , minimal invasion and positive efficacy for the treatment of joint gouty arthritis .