来源：风湿病与关节炎,2020,9（2）:21-23,34.

超声引导下碳酸氢钠溶液冲洗治疗痛风性膝关节炎的临床研究（临床研究）

冯明初，梁键锋，韩小华，瞿国萍

　　【摘　要】目的：观察超声引导下膝关节穿刺抽液后用质量分数为5%的碳酸氢钠溶液冲洗治疗痛风性膝关节炎的临床疗效。方法：将60例急性发作期单侧痛风性膝关节炎并髌上囊积液的患者随机分为治疗组和对照组，每组30例。对照组患者行超声引导下穿刺抽液后用生理盐水冲洗关节腔，术后标准药物治疗；治疗组患者行超声引导下穿刺抽液后用质量分数为5%的碳酸氢钠溶液冲洗关节腔，术后标准药物治疗。观察2组患者治疗前后患膝关节疼痛视觉模拟评分法（VAS）评分、Lysholm评分，以及术后6个月复发率。结果：治疗后，2组患者患膝关节VAS评分、Lysholm评分均明显优于治疗前（P < 0.05），术后7，14，30，90 d患膝关节VAS评分，术后30，90 d患膝关节Lysholm评分，治疗组优于对照组（P < 0.05）。治疗组复发率低于对照组，但差异无统计学意义（P > 0.05）。结论：超声引导下膝关节穿刺抽液后用质量分数为5%的碳酸氢钠溶液冲洗，能减少关节腔内尿酸结晶残余，相对于生理盐水冲洗，能减轻术后疼痛，改善关节功能。

　　【关键词】　痛风性膝关节炎；碳酸氢钠溶液；超声引导；冲洗

Clinical Study on the Treatment of Gouty Knee Arthritis by Washing with Sodium Bicarbonate Solution Under the Guidance of Ultrasound

FENG Ming-chu,LIANG Jian-feng,HAN Xiao-hua,QU Guo-ping

　　【ABSTRACT】Objective:To observe the clinical effect of 5% sodium bicarbonate solution in the treatment of gouty knee arthritis after ultrasound-guided knee joint puncture and extraction.Methods:Sixty patients with unilateral gouty knee arthritis and hydrops of suprapatellar bursa were divided into a treatment group and a control group,30 cases in each group.In the control group,the joint cavity was flushed with saline after ultrasound-guided puncture and extraction,and treated with standard medicine after operation.In the treatment group,the joint cavity was flushed with 5% sodium bicarbonate solution after ultrasound-guided puncture and extraction,and treated with standard medicine after operation.The VAS score and Lysholm score before and after treatment and the recurrence rate after 6 months were observed.Results:After the treatment,the VAS pain score and Lysholm score of the two groups were significantly better than those before the treatment（P < 0.05）.The VAS pain scores 7,14,30 and 90 days after the operation,and the Lysholm scores 30 and 90 days after the operation in the treatment group were better than those in the control group（P < 0.05）.The recurrence rate of the treatment group was lower than that of the control group,but the difference was not statistically significant（P > 0.05）.Conclusion:Washing with 5% sodium bicarbonate solution can reduce the residual of uric acid crystal in the articular cavity.Compared with washing with normal saline solution,it can reduce postoperative pain and improve joint function.

　　【Keywords】 gouty knee arthritis;sodium bicarbonate solution;ultrasound guid-ance;washing