关节镜下滑膜切除术治疗重度膝关节痛风性关节炎的疗效分析

Curative effect of arthroscopic synovectomy on severe gouty arthritis of knee

目的:探讨关节镜下滑膜切除术治疗重度膝关节痛风性关节炎的疗效。方法:回顾性分析我科2017年6月至2019年12月采用关节镜下滑膜切除术治疗的12例(12膝)重度膝关节痛风性关节炎患者的临床资料,随访了解症状缓解情况。结果:患者均行广泛切除病变滑膜及痛风石手术,重点清理前交叉韧带前方痛风石,术毕关节内各注射1支注射玻璃酸钠及曲安奈德注射液。术后住院6~14 d,切口愈合良好,随访时间平均3个月。患膝肿胀疼痛均明显缓解或消失,膝关节屈伸正常,症状无复发或加重,合并腘窝囊肿者亦未见复发。结论:关节镜治疗膝关节重度痛风性关节炎创伤小,可迅速减轻膝关节局部疼痛及肿胀,改善膝关节屈伸关节功能,短期内未见复发。

Objective:To investigate the curative effect of arthroscopic synovectomy on severe gouty arthritis of knee.Methods:From June 2017 to December 2019,the clinical data of 12 patients(12 knees)with severe gouty arthritis of knee treated by arthroscopic synovectomy in our department were retrospectively analyzed.Results:All patients underwent extensive synovectomy and gout stone resection,focusing on cleaning the gout stone in front of anterior cruciate ligament.One sodium hyaluronate and one triamcinolone acetonide injection were injected into each joint after operation.The postoperative hospital stay was 6-14 days,and the incision healed well;the average follow-up time was 3 months.And the swelling and pain of knees were significantly relieved or disappeared;the knee flexion and extension were normal;the symptoms did not recur or worsen,and the patients with popliteal cyst did not recur.Conclusion:Arthroscopic treatment of severe gouty arthritis of knee has less trauma,can quickly reduce the local pain and swelling of knee joint,improve the function of knee joint flexion and extension,and has no recurrence in a short time.