一例高压电击伤合并面神经损伤的护理-第三军医大学学报.doc

关节镜下行关节腔清理术治疗痛风性膝关节炎的临床护理 梅海娜 邓姝 黄合晴 刘春梅 陈春荣 张黎 代伟 【摘要】 目的 探讨痛风性膝关节炎在内科治疗后仍反复发作时，行关节镜辅助下的关节腔清理术治疗这些患者所采用的护理方法。方法 自2004年1月至2007年1月，对经内科治疗仍反复发作的31例痛风性膝关节炎患者，行关节镜下的关节腔清理术等。术后按关节镜手术进行专科护理，并坚持正规的降尿酸治疗和护理，对术中难以彻底清除的尿酸盐结晶结合术后短期冲洗并采用相应的护理措施。结果 痛风性关节炎的关节镜表现为特异性的白色团块状物质沉积在滑膜、软骨和其他关节内结构的表面。本组患者经积极治疗和精心护理，术后3l例切口甲级愈合，随访12～24个月中全部患者症状均较术前明显缓解。结论 关节镜手术对痛风性膝关节炎具有较高的治疗价值，手术创伤小，术后康复快。同时，有效的护理方法对确保手术疗效和防止手术并发症起了重要的促进作用。 【关键词】关节炎，痛风性； 护理；关节镜 Application arthroscopy for diagnosis and treatment of gouty arthritis Mei Han-na , Deng Shu , Huang He-qing , Liu Chun-mei , Chen Chun-rong , Zhang Li , Dai Wei . Center for Joint Surgery，Southwest Hospital，Military Medical University，Chongqing 400038，China 【Abstract】 Objective To investigate the use of arthroseopy for the diagnosis and treatment of gouty arthritis． Methods A total of 31 patients with gouty arthritis were diagnosed by arthroscopy between January 2004 and January 2007．Then biopsy and synovectomy were performed under arthroseope．Others cases were treated with debridement，synovectomy and microfracture because gouty arthritis hadn’t been controlled efectively by urieosurie agent． Results Arthroscopy showed specific white urate crystal deposited the surface of synovium and cartilage．After active treatment and intensive careJoint pain were eliminated rapidly in all cases and all the wounds were healed well after operation． Conclusions Arthroscopy is the reliable choice for the diagnosis and treatment of gouty arthritis．Advantages of this technique are minimal invasive，simple procedur，less time for operation and hospitalization with early rehabilitation，and all the combined lesion can be treated at the same．Postoperative caring following the criterion of routine nursing and rehabilitation is especially important during the t reatment 【Key words】Arthritis，gouty；Arthroscopes 痛风是高嘌呤代谢性疾病，四肢关节和肾脏是其好发部位。近年来，由于饮食结构的改变，痛风性关节炎的发病呈上升趋势[1]。保守治疗适用于大部分患者，但对临床表现不典型和发作频率逐渐增快的患者，常规内科治疗还是存在一定的局限性。本组对31例术前考虑痛风性膝关节炎，但内科降尿酸治疗后仍反复肿痛的患者采用关节镜辅