中国冶金工业医学杂志

全身多发巨大痛风石的外科手术综合治疗

单位：上海中冶职工医院骨科上海宝山 200941

分类号：中图分类号：R 684文献标志码：A文章编号：1005-5495(

出版年,卷(期):页码：2013,30(6):633-634

摘要：

摘要：目的探讨和评价以手术为主的综合疗法治疗全身多发巨大痛风石的效果。方法对2009—2012年我院收治的13例全身多发巨大痛风石患者，在发作间歇期或慢性期进行手术治疗，同时行一期关节功能重建术并结合药物、康复等综合治疗。结果手术部位共42处，其中在掌指关节及指间关节17处、第1跖趾关节13处、肘关节7处、腕关节5处。术后患者均获随访，随访期为6～35个月、平均13.5月；切口I期愈合39处、延期愈合3处，术后功能及外形均获改善，疼痛消失；术后痛风年均发作次数为(0.8±0.6)次，较术前的（4.8±1.1)次明显减少。结论采用以手术治疗为主的综合疗法是全身多发巨大痛风石的最佳治疗方法，术中保护关节功能及功能重建尤为重要，能改善临床症状、减少发作次数，有利于提高患者的生活质量。

Abstract:ObjectiveTo explore and evaluate the effect and the combined therapy of multiple enormous tophi all over the bodyMethodsSince 2009,13cases with multiple enormous tophaceous gout all over the body admitted to our hospital have been analyzed retrospectivelyForty-two lesions involved were treated including 17 ones on metacarpophalangeal joint and interphalangeal joint,13 ones on the first metatarsophalangeal joint of the foot,17 ones on elbow joint and 5 ones on wrist jointsDuring the intermission and chronicity,the comprehensive therapy centred on surgery including medication treatment and rehabilitation was implementedThe joint function was rebuilt at the same timeResultsThirteen cases gained satisfactory fellow-up visitAll cases were followed-up for 3to 35 months,with an average course 13.5 monthsIn the 42 surgical sites,primary wound healing was achieved in 39 cases while 3 cases had delayed healingJoint shape and function obviously improved the and pain associated with them disappeared in all the 13 casesThe incidence of acute recurrent attack with an average of(4.8±1.1)annually before the operation decreased obviously after the operation with an average of(0.8 ± 0.6)within one yearConclusionThe comprehensive therapy is the best treatment for patients with multiple enormous tophaceous gout all over the bodyIt is especially important to safeguard joint function during the operation and give functional restorationThis can also amend clinical symptom，decrease incidence of attack and improve the quality of life

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参考文献：

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