微创针刀镜治疗慢性痛风233例临床观察

发布时间：2018-01-18 11:24

  本文关键词：微创针刀镜治疗慢性痛风233例临床观察　出处：《中华中医药杂志》2017年10期 　论文类型：期刊论文

  更多相关文章： 微创针刀镜 慢性痛风 疗效 安全性 危险因素

【摘要】：目的:分析微创针刀镜对慢性痛风的疗效与安全性。方法:对233例住院并行膝/踝微创针刀镜治疗登记的痛风患者,根据病历记载及电话随访,评价关节疼痛术前术后的变化;术后1年关节肿痛的复发率;术后发作的间隔时间、疼痛程度、持续时间。结果:患者术后关节肿痛减轻率100%,关节肿痛消失率70.3%。在1年电话及门诊随访观察中发现,术后关节肿痛82%未再发作,16%有再次发作,但发作的间隔时间明显延长,发作时关节疼痛程度明显减轻、持续时间缩短,与针刀镜治疗前比较,差异有统计学意义(P0.01)。3例患者(2例为2型糖尿病患者,1例为长期使用糖皮质激素患者)术后发生膝关节感染,发生率1.29%。其余不良反应未发现。结论:微创针刀镜对慢性痛风有较好的疗效和安全性,存在关节腔感染的风险。糖尿病和长期使用糖皮质激素是引起关节腔感染的危险因素。
[Abstract]:Objective: to analyze the efficacy and safety of minimally invasive needle scalpel in the treatment of chronic gout. Methods: 233 patients with chronic gout who were hospitalized with knee / ankle minimally invasive needle knife were followed up by telephone according to medical records. To evaluate the changes of joint pain before and after operation. Recurrence rate of joint swelling and pain 1 year after operation; Results: the postoperative joint swelling and pain relief rate was 100%, and the joint pain disappeared rate was 70.3%. 82% cases of joint swelling and pain did not re-attack in 82%, but the interval of attack was significantly prolonged, the degree of joint pain was obviously alleviated and the duration was shortened during the attack, which was compared with that before the treatment with needle knife and endoscope. The difference was statistically significant in 2 patients with type 2 diabetes mellitus and 1 patient with long-term use of glucocorticoid. The incidence rate was 1.29.The other adverse reactions were not found. Conclusion: minimally invasive needle knife and mirror has better curative effect and safety for chronic gout. Diabetes and long-term use of glucocorticoid are risk factors for articular infection.
【作者单位】： 广州中医药大学第一附属医院风湿病科;
【分类号】：R687.4
【正文快照】： 慢性痛风,也称之为痛风的慢性期,主要表现是存在痛风石,慢性关节炎、尿酸结石和痛风性肾炎及并发症。此时痛风频繁发作,身体部位开始出现痛风石,随着时间的延长痛风石逐步变大。在关节方面,因其关节内存在大量痛风石沉积,致关节肿痛顽固,持续时间长,药物治疗难度大。2012年以，

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