中华骨与关节外科杂志
中華骨與關節外科雜誌
중화골여관절외과잡지
Chinese Journal Bone and Joint Surgery
2015年
2期
116-119
,共4页
陈峰%孔祥峰%杨波%钱军%张保中%翁习生%邱贵兴
陳峰%孔祥峰%楊波%錢軍%張保中%翁習生%邱貴興
진봉%공상봉%양파%전군%장보중%옹습생%구귀흥
痛风%痛风性关节炎%关节镜
痛風%痛風性關節炎%關節鏡
통풍%통풍성관절염%관절경
Gout%Gouty arthritis%Arthroscopy
背景:临床上痛风性膝关节炎患者并不少见,仅靠内科治疗效果可能欠佳。关节镜技术的应用领域日益广泛,但其在痛风性膝关节炎治疗中的疗效有待评估。<br> 目的:评价关节镜手术治疗痛风性膝关节炎的临床疗效及优势。<br> 方法:回顾性统计2000年1月至2012年12月北京协和医院确诊为痛风性膝关节炎并接受膝关节镜手术治疗的患者。记录患者术前、术后1周及术后6个月的血尿酸、红细胞沉降率、C反应蛋白水平,并进行VAS疼痛评分和Lysholm关节功能评分。<br> 结果:19例(26膝)纳入本研究。所有患者均经关节镜检及病理明确痛风性膝关节炎的诊断。与术前相比,术后1周的VAS评分及Lysholm评分显著改善(P<0.01)。所有病例无明显并发症发生。术后6个月,血尿酸水平、炎性指标(红细胞沉降率、C反应蛋白等)均显著下降,且VAS评分及Lysholm评分仍保持显著好转。仅2例因饮食控制欠佳暂时复发,经保守治疗后缓解。<br> 结论:膝关节镜在缓解痛风性膝关节炎患者的疼痛、改善关节功能方面短期疗效良好,可以辅助痛风的综合治疗。
揹景:臨床上痛風性膝關節炎患者併不少見,僅靠內科治療效果可能欠佳。關節鏡技術的應用領域日益廣汎,但其在痛風性膝關節炎治療中的療效有待評估。<br> 目的:評價關節鏡手術治療痛風性膝關節炎的臨床療效及優勢。<br> 方法:迴顧性統計2000年1月至2012年12月北京協和醫院確診為痛風性膝關節炎併接受膝關節鏡手術治療的患者。記錄患者術前、術後1週及術後6箇月的血尿痠、紅細胞沉降率、C反應蛋白水平,併進行VAS疼痛評分和Lysholm關節功能評分。<br> 結果:19例(26膝)納入本研究。所有患者均經關節鏡檢及病理明確痛風性膝關節炎的診斷。與術前相比,術後1週的VAS評分及Lysholm評分顯著改善(P<0.01)。所有病例無明顯併髮癥髮生。術後6箇月,血尿痠水平、炎性指標(紅細胞沉降率、C反應蛋白等)均顯著下降,且VAS評分及Lysholm評分仍保持顯著好轉。僅2例因飲食控製欠佳暫時複髮,經保守治療後緩解。<br> 結論:膝關節鏡在緩解痛風性膝關節炎患者的疼痛、改善關節功能方麵短期療效良好,可以輔助痛風的綜閤治療。
배경:림상상통풍성슬관절염환자병불소견,부고내과치료효과가능흠가。관절경기술적응용영역일익엄범,단기재통풍성슬관절염치료중적료효유대평고。<br> 목적:평개관절경수술치료통풍성슬관절염적림상료효급우세。<br> 방법:회고성통계2000년1월지2012년12월북경협화의원학진위통풍성슬관절염병접수슬관절경수술치료적환자。기록환자술전、술후1주급술후6개월적혈뇨산、홍세포침강솔、C반응단백수평,병진행VAS동통평분화Lysholm관절공능평분。<br> 결과:19례(26슬)납입본연구。소유환자균경관절경검급병리명학통풍성슬관절염적진단。여술전상비,술후1주적VAS평분급Lysholm평분현저개선(P<0.01)。소유병례무명현병발증발생。술후6개월,혈뇨산수평、염성지표(홍세포침강솔、C반응단백등)균현저하강,차VAS평분급Lysholm평분잉보지현저호전。부2례인음식공제흠가잠시복발,경보수치료후완해。<br> 결론:슬관절경재완해통풍성슬관절염환자적동통、개선관절공능방면단기료효량호,가이보조통풍적종합치료。
Background: Patients with gouty arthritis are common in practice and may be not controlled well only with drugs. Ar-throscopic treatment may be helpful in those cases, while the effectiveness should be evaluated. <br> Objective:To evaluate the effectiveness of the arthroscopic treatment in gouty arthritis. <br> Methods:The gouty arthritis patients who underwent arthroscopic surgery in Peking Union Medical College Hospital from January 2000 to December 2012 were retrospectively reviewed. Blood uric acid level, erythrocyte sedimentation rate (ESR), C reactive protein (CRP) were collected at the time of pre-operation, 1 week and 6 months of post-operation. The visual ana-logue scale (VAS) and Lysholm's function scoring were also evaluated. <br> Results:A total of 19 patients (26 knees) were confirmed with the diagnosis of gouty arthritis under arthroscopy. Statistic analysis showed that the VAS and Lysholm function scores were significant better at 1 week after the operation than those of pre-operation (P<0.01). No complication occurred. After 6 months follow-up, the level of blood uric acid and inflammato-ry factors (ESR and CRP) were significantly decreased, and the VAS and Lysholm scores remained improved as well. Only 2 cases had recurrent symptom due to poor diet control and relieved by drugs. <br> Conclusions:Knee arthroscopic debridment can help to relieve the pain in gouty arthritis patients. It has short-term effective-ness as well.