目的探讨关节镜下手术治疗慢性痛风性关节炎的方法和疗效。方法自2003年3月~2014年3月对154例反复急性发作的多关节慢性痛风性关节炎患者进行关节镜检查，利用射频汽化仪及刮匙除去紧密附着在关节软骨上的尿酸盐结晶，利用刨刀刨削充血、增生的滑膜及其附着的尿酸盐结晶；同时进行关节腔清理术，修整剥脱的关节软骨及受侵蚀的半月板；最后用大量关节腔冲洗液冲洗关节腔。术后抗炎镇痛，继续饮食控制及降尿酸治疗。结果154例患者术后病情均得到不同程度的缓解，135例术前关节功能障碍在术后得到明显改善。有3例双膝、踝、第一跖趾关节同时手术的患者，术后出现急性痛风发作，经关节腔穿刺放液，对症治疗，很快病情得到控制。经1~10年的随访观察，140例患者随访期间未再发生关节炎急性发作，14例患者有2~3次的急性发作，均与饮食控制不良有关。结论关节镜下手术治疗慢性痛风性关节炎是一种见效快，创伤小，效果稳定的方法，值得临床推广应用。但它仅是一种局部治疗方法,可以防止晚期骨性关节炎的早期发生,但不能代替排酸、抑酸及饮食控制的治疗。“,”Objective To investigate the use of arthroscopy for the diagnosis and treatment of gouty. Methods A total of 154 patients with gouty arthritis were diagnosed by arthroscopy between January 2001 and January 2013.Then biopsy and synovectomy were performed under arthroscope in al the patients.110 cases were treated debridement,synovectomy and radiofrequency ablation, because gouty arthritis had not been control ed ef ectively agent.Use the uricosuric agent at post-operation for avoiding symptom recur ing. Results Arthroscopy specific white urate crystal deposited the surface of synovium and cartilage.Joint pain was eliminated and al the wounds were healed wel after operation.Symptom had transient recur ence in 14 patients to 15 months fol ow- up. Conclusion Arthroscopy is the reliable choice for the diagnosis and treatment chronic gouty arthritis.Advantages of this technique are minimal invasive,simple procedure,less time for operation and hospitalization with early rehabilitation,and al the combined lesions can be treated at the same time.