关节镜辅助下行痛风性膝关节炎清理的围手术期护理

Application arthroscopically assisted treatment of gouty arthritis

目的探讨关节镜辅助下手术直接对痛风性关节炎进行清理术治疗的围手术期护理方法及近期疗效。方法自2004年1月至2005年12月,对39例关节镜探查术诊断痛风性关节炎的患者常规行关节清理术和滑膜病检术;术后对确诊患者坚持正规的降尿酸治疗;并抬高患肢,局部冰敷,短期灌洗关节,出院前进而作好出院指导。结果痛风性关节炎的关节镜表现为白色针状、絮状或团块状物质沉积在滑膜、软骨和其他关节内结构的表面。术后39例症状均明显缓解、住院时间(10±2)d,全部切口甲级愈合。结论关节镜手术对大关节的痛风性关节炎具有较高的诊断价值,还可同时处理关节内病变,减缓病程发展。及时准确的围手术期护理对确保手术疗效和防止手术并发症起了积极的促进作用。

Objective To investigate the use of arthroscopy for treatment of gouty arthritis and report the nursing and rehabilitation to the patients. Methods A total of 39 patients with gouty arthritis were diagnosed by arthroscopy between January 2004 and December 2005. Then biopsy and synovectomy were performed under arthroscope. Use the uricosuric agent at post-operation for avoiding symptom recurring. Results Arthroscopy showed specific white urate crystal deposited the surface of synovium and cartilage. Joint pain were eliminated rapidly in all cases and all the wounds were healed well after operation. Conclusion Arthroscopy is the reliable choice for the diagnosis and treatment of gouty arthritis. Advantages of this technique are minimal invasive,simple procedur,less time for operation and hospitalization with early rehabilitation, and all the combined lesion can be treated at the same time. Postoperative caring following the criterion of routine nursing and rehabilitation is especially important during the treatment.