足踝部痛风清除术的临床观察

Clinical observation on gout removal from the foot and ankle

摘要:

[目的]评价手术治疗足踝部痛风的临床疗效。[方法]回顾2016年12月—2022年6月接受手术治疗的足踝部痛风患者38例；观察并比较术前、术后3个月及末次随访血尿酸水平、痛风发作频率、视觉疼痛模拟评分（visual analogue scale，VAS）评价疼痛缓解和尿酸控制情况；观察并比较术前、术后3个月及末次随访美国矫形外科足踝协会（America orthopedic Foot＆Ankle Society，AOFAS）踝-后足评分患者踝关节功能；结果：38例患者随访6-12个月，纠正畸形、运动功能恢复满意，末次随访VAS评分由术前（6.3±1.1）分下降至（2.0±0.5）分，痛风发作频率由术前（3.5±0.9）次/月下降至（0.8±0.4）次/月，血尿酸水平由术前（586.8±90）μmol/L下降至（392.1±21.5）μmol/L，AOFAS评分由术前（66.1±3.7）分提高至（79.1±3.6）分（P＜0.05）。[结论]手术清理足踝部痛风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。

Abstract:

[Objective] To evaluate the clinical efficacy of surgical treatment of foot and ankle gout. [Methods] Thirty-eight patients with gout in the foot and ankle who underwent surgical treatment from December 2016 to June 2022 were reviewed; preoperative, 3-month postoperative, and final follow-up blood uric acid levels, frequency of gouty attacks, and visual analogue scale (VAS) for evaluating pain relief and uric acid control were observed and compared; Observe and compare the ankle function of patients with American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores at preoperative, 3 months postoperative and final follow-up; results: 38 patients were followed up for 6-12 months, with satisfactory correction of deformity and recovery of motor function, and the VAS scores at the final follow-up were decreased from preoperative ( 6.3±1.1) to (2.0±0.5), the frequency of gouty attacks decreased from preoperative (3.5±0.9)/month to (0.8±0.4)/month, the blood uric acid level decreased from preoperative (586.8±90)μmol/L to (392.1±21.5)μmol/L, and the AOFAS score increased from preoperative (64.6±4.5) to (79.1±3.6) points (P<0.05). [Conclusion] Surgical cleanup of foot and ankle gout can significantly reduce and control uric acid levels, effectively relieve pain and improve ankle function, with good clinical efficacy.