关键词: 痛风, 痛风石, 四肢, 外科手术, 血尿酸

Abstract: Objective:To explore the key points of preoperative preparation,the experience of operation and attentions of postoperative treatment of surgical treatment in multiple tophi in the extremities. Methods: A total of 23 cases of multiple tophi in extremities were selected,all were male;aged from 31 to 65 years old, average 48.7 years old;the course of the disease ranged from 4 to 20 years, with an average of 9.13 years;the blood uric acid before operation ranged from 380 to 665 μmol·L^-1,the level of uric acid was controlled by physicians before operation and the patients were not in the attack period. The patients underwent gout stone resection. Some of the patients underwent functional reconstruction and were treated with standardized gout medicine after operation. Results: Twenty-one cases of incision were grade A healing 2 weeks after operation,and 2 cases of incision still had uric acid salt exudation and healed after debridement suture. Among 23 cases,18 patients were followed for 4-12 months, an average of 8 months;5 patients were lost to follow-up. Compared with before operation, the joint function was improved, the degrees of joint activity were increased, and the discomfort was relieved in 16 patients after operation; there was no improvement in postoperative joint function in 2 patients, and the pain symptom in 1 patient with carpal tunnel syndrome was reduced. Conclusion: When properly indicated,the comprehensive therapy is the best treatment for the patients with multiple tophi in extremities.It is reliable and can improve the quality of life of the patients.

Key words: surgery, gout, tophi, uric acid, extremity