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目的:探讨不同治疗方法对急性痛风性膝关节炎的治疗效果。方法:自2006年9月~2008年3月共收治42例急性痛风性膝关节炎患者。对21例急性痛风性膝关节炎患者采取药物保守治疗,21例行关节镜手术配合药物治疗。两组治疗前后采用WOMAC评分对膝关节功能进行评定,用student-t检验进行统计学分析。结果:保守组:随访发现关节症状好转不明显,复发率19.05%;WOMAC评分治疗前49~72分,治疗后69~85分。关节镜手术配合药物组:随访发现关节症状均明显缓解,关节功能恢复良好,伤口甲级愈合,无术后并发症,6个月无复发病例;WOMAC评分治疗前49~71分,治疗后75~96分。两组治疗前后及之间有显著性差异,保守组(t=-9.864,P<0.001);关节镜手术配合药物组(t=-11.267,P<0.001);两组之间(t=-2.366,P<0.023)。结论:比较以上2种治疗方法,关节镜手术治疗急性痛风性膝关节炎具有创伤小、起效快、效果明显、关节功能恢复满意等特有优势,结合药物治疗,能取得良好的治疗效果。
Objective: To investigate the therapeutic effect of different treatment methods on acute gouty arthritis. Methods: From September 2006 to March 2008, 42 patients with acute gouty arthritis were enrolled. Twenty-one patients with acute gouty arthritis were treated conservatively and 21 patients underwent arthroscopic surgery combined with medication. Before and after treatment, the WOMAC score was used to evaluate the knee joint function, and statistical analysis was performed with Student-t test. Results: In the conservative group, the improvement of joint symptoms was not obvious at follow-up. The recurrence rate was 19.05%. The WOMAC score was 49-72 before treatment and 69-85 after treatment. Arthroscopic surgery combined with drug group: Follow-up found that joint symptoms were significantly relieved, joint function recovered well, wound healing, without postoperative complications, 6 months without recurrence; WOMAC score 49 to 71 points before treatment 75 ~ 96 points. (T = -9.864, P <0.001); arthroscopic surgery combined with drug group (t = -11.267, P <0.001); There was significant difference between two groups before and after treatment (t = 2.366, P <0.023). Conclusion: Comparing the above two kinds of treatment methods, the arthroscopic treatment of acute gouty arthritis has the advantages of small trauma, rapid onset, obvious effect and satisfied joint function recovery. Combined with medical treatment, good therapeutic effect can be obtained.