痛风性膝关节炎的关节镜诊断和治疗

Diagnosis and Treatment of Knee Gouty Arthritis by Arthroscopy

目的探讨关节镜对痛风性膝关节炎的诊断价值和近期疗效。方法对37例痛风性膝关节炎患者作膝关节镜检查观察其镜下表现,多点取病变组织做病理检查,将水肿增厚的滑膜和尿酸盐结晶尽可能清除,彻底冲洗。术后观察手术疗效,常规服用治疗痛风的药物。结果术前16例误诊为其他关节炎者术中确诊为痛风性关节炎,21例术前拟诊痛风性关节炎术中得到进一步的证实。31例均获随访,时间2～36个月,膝关节肿胀、疼痛明显减轻,功能改善明显,Lysholm评分由术前53分到末次随访时提高到90分,疗效评定:优15例,良22例。结论关节镜手术能较直观诊断痛风性关节炎,近期疗效满意。

Objective To study the diagnostic value and therapeutic effect in short-time after arthroscopy forgouty arthritis ofknee.Methods Totally 37 cases of knee gouty arthritis were admitted.The kneeswere observed under the arthroscopy,thenmultiple points of synovial membrane were harvested forhistopathological examination and uric crystalwereremoved and hyperplastic synovium were resected.Results The preoperative misdiagnosis 16 cases and 21 arthritis were diagnosed of acute gouty arthritis before operation,were all finally diagnosed of acute gouty arthritis through pathologic examination.After the arthroscopy,the pain and the swelling relieved quickly,the function of the knees improved obviously during 2～36 months following up.The Lysholm scores was improved from 53 points preoperatively to 90 points,the outcomes were excellent in 15,good in 22 cases.Conclusion Arthroscopy has very important value in the diagnosis and treatment of acute gouty arthritis,and the short-term therapeutic effect is satisfactory.