| 毛小成,黄亚男,赵枫,等.关节镜下高频脉冲冲洗治疗膝关节痛风性关节炎的疗效分析.骨科,2021,12(6): 535-540. |
| 关节镜下高频脉冲冲洗治疗膝关节痛风性关节炎的疗效分析 |
| High-Frequent Pulse Irrigating under Arthroscopy for Knee Gouty Arthritis |
| 投稿时间：2021-05-26 |
| DOI：10.3969/j.issn.1674-8573.2021.06.010 |
| 中文关键词: 关节镜检查 高频脉冲冲洗 痛风性关节炎 膝关节 |
| 英文关键词: Arthroscopy High-frequent pulse irrigating Gouty arthritis Knee |
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| 中文摘要: |
| 目的 探讨关节镜下高频脉冲冲洗治疗膝关节痛风性关节炎的疗效。方法 2007年3月至2019年1月我科共收治膝关节痛风性关节炎79例，其中男69例，女10例；年龄为（40.6±10.1）岁（21~52岁）。根据手术方法将病人分为脉冲组和对照组，脉冲组44例在传统关节镜手术的基础上，联合高频脉冲清理痛风结晶；对照组35例采用关节镜下刨削刀、刮匙清除痛风结晶。记录两组病人的手术一般情况；统计脉冲组的清理成功率；记录术后的血尿酸、C反应蛋白水平、全身痛风急性发作的例数、疼痛视觉模拟量表（visual analogue scale，VAS）评分、西安大略和麦克马斯特大学（the Western Ontario and McMaster Universities Arthritis Index，WOMAC）骨关节炎指数、Kellgren-Lawrence分级。结果 脉冲组的总体手术时间、关节软骨和半月板清理时间、术后1周及2年的VAS评分和WOMAC指数均显著低于对照组，组间比较，差异有统计学意义（P＜0.05）；脉冲组的全身痛风急性发作率（4.5%）显著低于对照组（22.9%），Kellgren-Lawrence分级明显优于对照组，组间比较，差异有统计学意义（P＜0.05）。脉冲组内关节软骨和半月板清理成功率达到97.7%（43/44），但交叉韧带和滑膜的清理成功率仅为6.8%（3/44）和15.9%（7/44）。结论 关节镜下高频脉冲冲洗治疗痛风性关节炎，具有操作简便、高效、损伤小的优点，尤其对关节软骨和半月板的清理具有满意的效果，可作为常规清理方式的辅助手段。 |
| 英文摘要: |
| Objective To evaluate the efficacy of high-frequent pulse irrigating under arthroscopy for knee gouty arthritis. Methods Between March 2007 and January 2019, 79 patients suffering from knee gouty arthritis were treated. There were 69 males and 10 females. The age was (40.6±10.1) (21-52) years old. All patients were divided into two groups according to the surgical procedures. Thirty-five patients in control group were treated with arthroscopic planer and curette, and 44 patients in pulse group were treated with arthroscopic high-frequent pulse irrigating. The operation indexes of the two groups were recorded, and the cleaning success rate of pulse group was calculated. The level of serum uric acid and C-reactive protein (CRP), rate of acute gouty attack, visual analogue scale (VAS) score, the Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, Kellgren-Lawrence classification were recorded. Results The total operation time, the operation time of cartilage and meniscus, and the VAS score, WOMAC score at 1st week and 2nd year postoperatively in pulse group were significantly reduced as compared with those in control group (P＜0.05). Rate of acute gouty attack (4.5%) in pulse group was lower than that in control group (22.9%), and Kellegren-Lawrence classification in pulse group was better than that in control group (P＜0.05). The successful rate with irrigating at cartilage and meniscus was 97.7% (43/44), and 6.8% (3/44) at cruciate ligament and 15.9% (7/44) at synovitis. Conclusion High-frequent pulse irrigating under arthroscopy is easy, efficient and has mild injury for knee gouty arthritis, especially for cartilage and meniscus, and could be a supplementary means. |
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