背景:痛风是一种慢性疾病,其特征是尿酸单钠晶体沉积。Tophi在一些未经治疗或不受控制的痛风患者中发展,导致溃疡,化妆品问题,关节运动的机械障碍,关节损伤和肌肉骨骼残疾。目前,痛风托比的治疗是有争议和具有挑战性的。手术和内科治疗都有局限性,需要在临床实践中进一步探索。
方法:在病例1中,我们治疗了1例糖尿病足溃疡合并多发性痛风托喜的严重感染患者。制定了系统的管理策略,以闭合伤口并挽救肢体。溃疡半年后成功愈合。在病例2中,通过手术治疗和装载万古霉素的骨水泥植入,切除了位于左足第一meta趾关节中的巨大痛风石。在案例3中,我们提出了一例痛风tophi的案例,该案例已通过标准化的系统医疗管理解决。
方法:3例患者均诊断为痛风伴痛风沉积,尽管还有其他不同的合并症。
方法:在病例1中,我们使用清创逐渐去除痛风托喜。在病例2中,通过外科手术切除了巨大的痛风石。在病例3中,痛风石经过药物标准化治疗后消失,饮食和生活方式管理。
结果:3名患者根据其具体情况接受了不同的治疗疗法以去除痛风痛风石。
结论:我们探索了通过手术或其他干预措施结合药物治疗对痛风痛风的有效干预措施。
BACKGROUND: Gout is a chronic disease characterized by deposition of monosodium urate crystals. Tophi develop in some individuals with untreated or uncontrolled gout, which leads to ulcerations, cosmetic problems, mechanical obstruction of joint movement, joint damage and musculoskeletal disability. Currently, the treatment of gouty tophi is controversial and challenging. Both surgical and internal medical treatments have limitations and require further exploration in clinical practice.
METHODS: In
Case 1, we treated a patient with severe infection of diabetic foot ulcers with concomitant multiple gouty tophi in the same limb. A systematic management strategy was formulated to close the wound and save the limb. The ulcers healed successfully after half a year. In Case 2, a giant gouty tophi located in the first metatarsophalangeal joint of the left foot was removed by surgical treatment and vancomycin-loaded bone cement implantation. In
Case 3, we present a
case of gouty tophi that was resolved by standardized systemic medical management.
METHODS: Three patients were all diagnosed with gout accompanied by gouty deposition, although there were other different comorbidities.
METHODS: In
case 1, we used debridement to gradually remove gouty tophi. In
case 2, the giant gouty tophi was removed by surgical operation. In
case 3, the gouty tophi disappeared after standardized treatment with medicine, diet and lifestyle management.
RESULTS: Three patients underwent different treatment therapies to remove gouty tophi based on their specific conditions.
CONCLUSIONS: We explored effective interventions for tophi in gout by surgical or other interventions in combination with pharmacotherapy.