PDF(Pubmed)
Abstract：
Background: Current treatments with urate-lowering therapy (ULT) are effective for most patients with gout. However, approximately 10% of these patients do not respond well to ULT and develop chronic tophus lesions. Objective: This study aimed to evaluate the efficacy of surgery involving the shaver technique against chronic tophus lesions. Methods: This single-center, retrospective cohort study included 217 patients who had cumulatively undergone 303 shaver-assisted procedures between 2002 and 2018. Surgical outcomes were assessed in terms of the length of hospital stay (LOS) and wound healing time. Results: LOS and wound healing time were longer in patients with a preoperative tophus infection and lower extremity lesions than in those without infection and with upper extremity lesions (respectively, LOS: 12.7 vs. 8.6 days; wound healing time: 22.7 vs. 16.3 days). However, factors such as age, sex, body mass index, renal function, or uricemia level exerted no significant effect on surgical outcomes. Conclusion: Surgery involving the shaver technique should be performed before tophus infection. Clinical outcomes tend to be better for upper extremity lesions than for lower extremity lesions.
摘要：
背景：目前使用降尿酸治疗（ULT）对大多数痛风患者有效。然而,这些患者中约有10％对ULT反应不佳，并发展为慢性痛风石病变。目的：本研究旨在评估涉及剃须刀技术的手术治疗慢性痛风症的疗效。方法：这种单中心，回顾性队列研究纳入了217例患者,这些患者在2002年至2018年期间累计接受了303例剃须刀辅助手术.根据住院时间（LOS）和伤口愈合时间评估手术结果。结果：术前痛风石感染和下肢病变的患者的LOS和伤口愈合时间比无感染和上肢病变的患者长（分别为，LOS：12.7vs.8.6天；伤口愈合时间：22.7vs.16.3天）。然而,年龄等因素,性别,身体质量指数,肾功能,或尿酸血症水平对手术结局无显著影响.结论：应在痛风石感染之前进行涉及剃须刀技术的手术。上肢病变的临床结果往往比下肢病变更好。
