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目的探讨关节镜辅助下的关节腔探查清理术对痛风性关节的诊断和治疗意义及手术技巧。方法自2006年4月至2010年1月,对25例膝踝关节痛风性关节炎患者行关节镜检诊,同时进行关节清理术,利用手科弯头剥离匙推刮紧密附着在关节软骨上的尿酸盐结晶,利用刨刀清除增生的滑膜及游离的尿酸盐结晶。术后予常规内科降尿酸治疗和短期关节灌洗,并强调术后关节功能锻炼。结果痛风性关节炎关节镜下均有见大量白色絮状或成片白垩状结晶沉积在滑膜、软骨和其他关节内结构的表面特异性的表现;7例误诊患者通过关节镜检明确诊断,全部25例患者术后随访3-20个月,全部25例患者术后肿痛症状明显缓解,关节功能恢复快。参照《中医风湿病学》中的疗效评价标准,有效率100%。结论关节镜手术对痛风性膝关节炎具有较高的诊断和治疗价值,手术创伤小,术后康复快。
Objective To investigate the significance of diagnosis and treatment of gouty arthroplasty with surgical assisted arthroscopic exploration and surgical techniques. Methods From April 2006 to January 2010, 25 patients with knee, ankle arthritis and gout arthritis underwent arthroscopic examination and joint debridement. The hand was bended with a peeler spoon to push and adhere tightly to the articular cartilage Urate crystals, the use of planing knife removal of hyperplastic synovium and free urate crystals. Postoperative conventional uric acid reduction therapy and short-term joint lavage, and emphasize postoperative joint functional exercise. Results Gout arthroscopy showed a large number of white flocculent or chalky chalk deposits in the synovial, cartilage and other intraarticular structures of the surface-specific performance; 7 cases of misdiagnosed patients confirmed by arthroscopy, All 25 patients were followed up for 3-20 months. All 25 patients had obvious relief of swelling and pain symptoms and quick recovery of joint function. With reference to “Chinese medicine rheumatology” in the evaluation of the efficacy of the efficiency of 100%. Conclusion Arthroscopic surgery has high diagnostic and therapeutic value for gouty arthritis, with less trauma and quick recovery.