微创针刀镜在膝关节痛风性关节炎中的应用价值及安全性  

The application value and safety of minimally invasive acupotomy in gouty arthritis of the knee joint

作　　者：谢悦胜[1] 张晓[1] 罗日强[1] 张光峰 XIE Yuesheng;ZHANG Xiao;LUO Riqiang;ZHANG Guangfeng(Guangdong Academy of Medical Sciences,Department of Rheumatology,Guangdong General Hospital,Guangzhou,Guangdong 510080,China)

机构地区：[1]广东省医学科学院广东省人民医院风湿免疫科,广东广州510080

出　　处：《安徽医药》2018年第4期635-638,共4页Anhui Medical and Pharmaceutical Journal

摘　　要：目的对膝关节痛风性关节炎患者使用微创针刀镜手术诊治价值进行探究,并对其安全性进行分析。方法回顾性分析41例膝关节痛风性关节炎患者的临床资料,全部患者均应用微创针刀镜手术进行治疗,评估其诊治过程,对比手术前后患者膝关节功能评分、VAS评分变化情况。结果 41例患者中,镜下均可见尿酸盐结晶。18例患者行滑膜病理检查,17例符合痛风典型病理表现。41例患者中痊愈20例,显效11例,有效7例,3例患者治疗无效,临床有效率为92.68%;41例膝关节痛风性关节炎患者治疗后Lysholm评分为(96.21±1.32)分,明显高于治疗前的(54.51±1.26)分,差异有统计学意义(P<0.05);41例膝关节痛风性关节炎患者治疗后VAS评分为(3.51±0.96)分,明显低于治疗前的(8.05±1.02)分,差异有统计学意义(P<0.05)。41例患者中无严重并发症发生,且术后的恢复较好。结论应用微创针刀镜诊治膝关节痛风性关节炎患者,不仅可作为诊断膝关节痛风性关节炎的重要辅助手段,同时疗效显著,并发症少,且可明显改善患者膝关节功能评分与VAS评分,值得临床给予应用与推广。Objective To explore the value of minimally invasive acupotomy for the patients with gouty arthritis of the knee joint,and to analyze the safety.Methods The clinical data of41patients with gouty arthritis of the knee joint in the Department of Rheumatology of our hospital were retrospectively analyzed,all patients were treated by minimally invasive acupotomy,and their diagnosis and treatment process were evaluated.The changes of knee function score and VAS score before and after operation were compared.Results The crystallization of urate was found in all41patients.The pathological examination of synovial membrane was performed in18patients,and17cases were conformed to the typical pathological manifestations of gout.Among41patients,20cases were cured,11cases were excellence,7cases were effective,3cases were invalid,the clinical curative effect was92.68%.The Lysholm score of41patients with gouty arthritis of the knee joint after treatment was(96.21±1.32)scores,which was significantly higher than that of before treatment(54.51±1.26)scores,the difference was statistically significant(P<0.05).The VAS score of41patients with gouty arthritis of the knee joint after treatment was(3.51±0.96)scores,which was significantly lower than that before treatment(8.05±1.02)scores,the difference was statistically significant(P<0.05).There were no serious complications in41patients,and the postoperative recovery was better.Conclusions The application of minimally invasive acupotomy in the diagnosis and treatment of gouty arthritis of the knee joint can not only be used as an important auxiliary means for the diagnosis of gouty arthritis of the knee joint,but also the curative effect is remarkable,complications is less,and it can significantly improve the knee joint function score and VAS score,which is worthy of clinical application and promotion.

关 键 词：膝关节 痛风性关节炎 微创针刀镜 安全性 

分 类 号：R687.4[医药卫生—骨科学]