足踝部痛风石清除术的早期临床观察  

Early clinical observation on surgical removal of gouty tophi in foot and ankle

作　　者：林泽玉 曲军杰 孙德麟 王彦超 崔建强 康乐 徐林 LIN Ze-yu;QU Jun-jie;SUN De-lin;WANG Yan-chao;CUI Jian-qiang;KANG Le;XU Lin(Department of Hand and Foot Surgery,Yantai Affiliated Hospital,Binzhou Medical Universi-ty,Yantai264100,China)

机构地区：[1]滨州医学院烟台附属医院手足外科,山东烟台264100

出　　处：《中国矫形外科杂志》2024年第11期1046-1049,共4页Orthopedic Journal of China

摘　　要：[目的]探讨手术切除足踝部痛风石的临床疗效。[方法]回顾性分析2016年12月—2022年6月接受足踝部痛风石切除术38例患者的临床资料。评价临床及检验结果。[结果]所有患者均顺利完成手术,术中未出现并发症,随访6~12个月。与术前相比,末次随访时,VAS评分[(6.3±1.1),(2.0±0.5),P<0.001]、急性痛风发作频率[(3.5±0.9)次/月,(0.8±0.4)次/月,P<0.001]均显著减少,AOFAS评分[(66.1±3.7),(79.1±3.6),P<0.001]、踝背伸ROM[(8.8±2.8)°,(16.1±2.4)°,P<0.001]、踝跖屈ROM[(28.4±7.2)°,(41.6±4.5)°,P<0.001]显著增加。检验方面,与术前相比,末次随访时血尿酸水平[(586.8±90)μmol/L,(392.1±21.5)μmol/L,P<0.001]显著降低。[结论]手术清理足踝部痛风石可显著降低并控制尿酸水平,有效缓解疼痛、改善踝关节功能,临床疗效良好。[Objective]To investigate the clinical outcomes of surgical removal of gouty tophi in foot and ankle.[Methods]A retrospec⁃tive research was performed on 38 patients who underwent surgical removal of tophi in foot and ankle from December 2016 to June 2022.The clinical and laboratory data were evaluated.[Results]All patients had tophi in foot and ankle removed successfully with no complica⁃tions,and followed up from 6 to 12 months.Compared with those preoperatively,the VAS score[(6.3±1.1),(2.0±0.5),P<0.001]and acute gout attack frequency[(3.5±0.9)times/month,(0.8~0.4)times/month,P<0.001]significantly decreased,whereas the AOFAS score[(66.1±3.7),(79.1±3.6),P<0.001],ankle dorsal flexion ROM[(8.8±2.8)°,(16.1±2.4)°,P<0.001]and ankle plantar flexion ROM[(28.4±7.2)°,(41.6±4.5)°,P<0.001]increased significantly at the latest follow up.In addition,compared with that preoperatively,the serum uric acid significant⁃ly declined at the latest follow up[(586.8±90)μmol/L,(392.1±21.5)μmol/L,P<0.001].[Conclusion]Surgical removal of gouty tophi in foot and ankle does significantly reduce and control uric acid level,effectively relieve pain and improve ankle joint function,with good clinical ef⁃ficacy.

关 键 词：痛风 足踝 手术 临床疗效 

分 类 号：R687[医药卫生—骨科学]