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

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。

Abstract:

[Objective] To investigate the clinical outcomes of surgical removal of gouty tophi in foot and ankle. [Methods] A retrospective 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 complications, 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 significantly 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 efficacy.