Objective To explore the surgical treatment and the effect of perioperative medical treatment for patients with hand gouty stone. Methods From May 2013 to May 2016,11 patients with hand gout stones were selected. On the basis of improving the relevant examinations,the patients were given a low purine diet before operation. The patients were treated with drugs to reduce uric acid,alkalize urine and analgesia. After the uric acid dropped to normal or close to normal,the gout stones were excised. After the operation,preoperative treatment was performed and the incisions were regularly changed to instruct the patients to perform functional exercises on their hands. Results All the 11 patients were followed up for 8 to 26 months. The average follow-up period was 13.5 months. The incisions of 10 patients healed in one stage. Only 1 case of the incisions healed badly. After 3 weeks of dressing change,11 patients had no recurrence of gout stones,good appearance of hands and good functional recovery. Conclusion The treatment of gout stone is based on surgical operation,and the close cooperation of internal medicine is needed during the perioperative period. It can achieve good results in excising gout stone,avoiding recurrence and improving the appearance and function of hand and foot.%目的 探讨手部痛风石患者的外科手术治疗及围手术期内科治疗的效果.方法 选取2013年5月至2016年5月住院治疗的11例手部痛风石的患者,在完善相关检查的基础上,在手术前对患者实施低嘌呤饮食,利用药物降尿酸、碱化尿液、镇痛等治疗,在尿酸降至正常或接近正常后行痛风石切除术,术后继续术前治疗,切口处定期换药,指导患者进行手部的功能锻炼.结果 本组11例患者全部获得随访,随访8~26 个月,平均13.5个月,10例患者切口一期愈合,仅1例切口出现愈合不良,予以换药处理3周后愈合,术后11例患者痛风石未复发,手部外观良好,功能恢复良好.结论 痛风石的治疗以外科手术为主,围手术期需要内科的密切配合,能达到切除痛风石、避免复发、改善手足外观及功能的良好效果.
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