手部痛风的手术治疗

目的 探讨手部痛风的手术疗效及诊治经验。方法 对16例手部痛风伴有结石、关节肌腱粘连及腕管综合征的患者，采用单纯痛风石切除5例，痛风石切除同时行肌腱粘连松解及部分指浅屈肌腱切除5例，痛风石切除、腕管切开减压正中神经或指神经松解6例。术前、术后1周内服用痛风利仙50mg／次，每日2次，西乐葆0．2g/次，每日1次。结果 术后全部病例均切除了痛风结石，同时纠正了手指的外形畸形，手指麻木症状好转，皮肤无坏死，伤口均Ⅰ期愈合。术后随访5个月～5年，未见痛风石复发，手指外形及功能满意。结论 手术治疗对痛风晚期进行痛风石清除有效，同时也可纠正畸形及外形，改善手功能。

Operative treatment of gout in the hand

Objective To report results and experience of treating gout of the hand surgically. Methods 20 hands of 16 patients with tophus accompanied by joint or tendon adhesion and carpal tunnel syndrome were surgically treated. 5 cases underwent extirpating of the tophus, 5 had tophus excision and tenolysis, 6 had tophus excision plus digital nerve releaseor carpal tunnel release. Results Postoperative follow-up ranged from 6 months to 5 years. All the tophus was gone without recurrence. Primary healing of the wound was achieved in all case with no skin nccmsis. Deformity of the hand was corrected. Neuropathy symptoms were relieved. Both appearance and function of the hand was greatly improved. Conclusion Operative treatment can effectively remove tophus in late gout, and correct deformity and improve function of the hand.