髋关节痛风性关节炎34例临床分析

摘要

目的 分析累及髋关节的痛风性关节炎的临床相关资料,提高对该疾病的认识和诊治能力.方法 回顾性分析2014年1月至2017年3月在我院就诊的痛风性关节炎的病例,根据是否累及髋这个特殊部位分为髋关节组和常见关节组(髋关节不累及),其中髋关节组进一步根据病情分为急性组和慢性组,比较各组病例的基本临床资料.结果 与常见关节组相比,髋关节组病例通常合并肥胖或既往患侧髋部外伤史,男性患者发病年龄轻,同时髋关节组病例全部为单侧髋部受累,局部无明显红肿热痛.CT及超声检查可为早期诊断提供辅助,必要时需手术或病理检查确诊.结论 累及髋关节的痛风性关节炎临床上缺乏特异诊断标准,容易与髋部其他相关疾病混淆,在髋部疾病的临床诊断不明确时,应考虑髋关节痛风性关节炎的可能性.%Objective To improve the diagnosis and treatment of hip gouty arthritis.Methods Retrospective analysis of cases of gouty arthritis from 2014 January to 2017 March was conducted.Patients with gouty arthritis were divided into hip joint group and common joint group (without invaded hip) and hip joint group was further divided into acute group and chronic group.Clinical data of each group were compared.Results Compared with common joint group,hip joint group usually combined with obesity or previous ipsilateral hip trauma history.Male patients in hip joint group were younger and the patients with unilateral hip involvement were without obvious local swelling,heat and pain.CT scan and sonography can provide assistance for early diagnosis and operation or pathological diagnosis was needed for the confirmation when necessary.Conclusions Hip gouty arthritis lacks specific diagnostic criteria in clinic,and is easily confused with other diseases associated with hip.Therefore,the possibility of the hip gouty arthritis should be taken into consideration when the diagnosis of the hip disease is not clear.