痛风结节刮除术后急性痛风性关节炎复发的相关因素分析

Analysis of Related Factors of Recurrence of Acute Gouty Arthritis after Curettage of Gouty Nodules

摘要: 目的：探讨行痛风结节刮除术后急性痛风性关节炎复发的相关影响因素。方法：回顾性分析2018年5月~2021年5月112例全部为男性患者在我院行痛风结节刮除术的临床资料，包括一般属性资料、临床特征、生化检验情况等，将术后1周内出现急性痛风性关节炎复发患者作为观察组，未出现相关症状患者作为对照组，并采用多因素Logistic回归模型分析术后痛风关节炎急性复发的相关因素。结果：共有105例符合纳入标准，其中有38例患者术后出现急性痛风性关节炎复发，发生率36.2%，总共15个变量纳入分析，单因素分析中有8个变量观察组与对照组差异有统计学意义，多因素Logistic回归分析结果显示：血肌酐、手术时间是术后急性痛风关节炎复发的独立危险因素，体重指数(BMI)偏高、围术期应用秋水仙碱、术中碳酸氢钠液浸泡是术后急性痛风关节炎复发的独立保护因素。结论：血肌酐偏高、手术时间长都会增加痛风结节刮除术后急性痛风性关节炎复发风险。围术期使用秋水仙碱，术中行碳酸氢钠液浸泡对于预防痛风结节刮除术后急性痛风性关节炎复发非常有必要。

Abstract: Purpose: To explore the related factors of recurrence of acute gouty arthritis after curettage of gouty nodules. Method: The clinical data of 112 male patients who underwent curettage of gout nodules in our hospital from May 2018 to May 2021 were analyzed retrospectively, including general attribute data, clinical features, biochemical tests, etc. Patients with acute gouty arthritis recurrence within 1 week after operation were taken as the observation group, and patients without related symptoms as the control group, and the related factors of acute recurrence of gouty arthritis after operation were analyzed by multivariate Logistic regression model. Result: A total of 105 patients met the inclusion criteria, among which 38 patients had recurrence of acute gouty arthritis after operation, with an incidence rate of 36.2%. A total of 15 variables were included in the analysis. In the univariate analysis, there were 8 variables with statistical differences between the observation group and the control group. The results of multivariate Logistic regression analysis showed that serum creatinine and operation time were independent risk factors for recurrence of acute gouty arthritis after operation, and the high body mass index (BMI), perioperative application of colchicine and intraoperative soaking in sodium bicarbonate are independent protective factors for postoperative recurrence of acute gouty arthritis. Conclusion: High serum creatinine and long operation time will increase the risk of recurrence of acute gouty arthritis after curettage of gout nodules. It is necessary to use colchicine during perioperative period and soak in sodium bicarbonate solution during operation to prevent recurrence of acute gouty arthritis after curettage of gouty nodules.