外科手术结合内科综合治疗痛风石的临床分析

Combination of surgical ang medical procedure on tophic patients

目的 探讨和总结痛风石的手术治疗方法及结合和围手术期内科综合治疗的临床疗效.方法 对13例四肢多发及单发痛风石患者在内科综合治疗的基础上,待血尿酸降至正常或接近正常值时行外科手术干预.结果 本组13例全部得到随访,随访时间6～18个月,平均10.5个月.切口全部愈合,无一处感染.患处外观及关节功能良好,血尿酸控制在正常范围,无一例复发.结论 外科手术结合内科综合治疗四肢痛风石取得良好的效果,围手术期内科的综合治疗为手术安全及术后效果提供有利的保障,手术治疗是延缓疾病进展、缓解局部症状、减少疾病复发的手段,长期的血尿酸监测及内科的综合治疗是预防疾病复发的有效措施.

Objective To assess the surgical and perioprational medical methods for treatment of gouty tophus. Methods Surgeries were performed on 13 patients with multiple or single extremity gouty tophus after systematic medication had lowered the blood uric acid level to around normal. Results All 13 patients were followed up for 6-18 months （average 10.5 months）. All acchieved uncomplicated incision heal. The involved limb recovered cosmetically as well as funtionally. Blood uric acid stayed normal with absent recurrence. Conclusion Combination of surgical and medical procedure is indicated for gouty tophus. Perioprational medical treatment facilitates successful surgery to suppress disease progress, alleviate local symptom and avoid recurrece. Prophylaxis of tophus is possible with longterm monitor of blood uric acid and systematic medical treatment.