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Thursday, July 3, 2008

Tophi can take stone surgery

According to statistics, gout patients in about 20% to 30% of body surface of a stone, the stone occurred in the vicinity of the joints and limbs, and joint function in patients with serious decline, maimed, or even loss of self-care ability. Some patients stone not long after surgery wound healing, some doctors do not want to do this surgery. Gout can then stone surgery stones » How surgery » Tophi formation of tophi is because long-term patients increased serum uric acid, uric acid formation of sodium (MSU), deposited in various tissues and organs formed stones. In addition to internal organs outside the brain can be a stone to see most of the kidney stone. Surface stones mainly occurred in the vicinity of the joints and limbs, the stone sooner or later, the growth rate and increased blood levels of uric acid, hyperuricemia duration, and acute arthritis in the same number of joint attack was positively correlated. Stone serious bone and joint, hand or foot bones of several pieces of stone were all occupied. If the initial stones in the soft tissue, the skin can thinning, Pokui, MSU crystallization of the outflow or small stones to form ulcers and sinus, repeated bacterial infections, break a few years or 10 years can not be healed, the merger also osteomyelitis Are not uncommon. So as soon as possible surgery stones. ① preoperative preparation before the surgery should be the first of serum uric acid to normal or near normal levels, after a result of uric acid avoid excessive impact on healing. ② need to physically do the surgery X-ray imaging, X-ray easily through the stone, but the soft tissue in the stone often can be seen surrounding the density slightly higher than the whole of the massive image. X-ray through the little bone, stone density was significantly lower than bone density, X-ray film common wormhole-like, Chuanzao kind, the kind of low-density cellular bone defects, serious one or several pieces of bone and parts All missing. Gout is a metabolic syndrome ③ a disease, should be actively treating hypertension, diabetes and renal dysfunction and other merger-related diseases, to be in stable condition after surgery. Surgical operation is primarily aimed at joints and near the stone: ① where stone diameter of more than 2 cm or more than a stone so that the pool in uric acid increased significantly, the impact of descending uric acid treatment. ② have ulcers, sinus or osteomyelitis formed to break long-term, non-union. ③ stones affect joint function, significantly restricted the activities of patients. If surgery is not invaded stone and bone joints, regardless of whether the merger ulcer and sinus, the majority can and will be coated with stone removed, the incision in five to ten days to heal. Such as stone and bone and joint deep, large piece of stone removed, should no longer use keys, and other equipment will be scraping the remnants of stone fragments as far as possible eliminate, or stone debris will continue in the overflow from the wound, healing effects, drainage should be done at this time Treatment, more than in January after the drainage is not sealed, should be done in the second removal. A small number of serious bone damage, the need to buy bones, joints integration, and the truncated limb, so to promote tophi surgery sooner the better. ① down after dealing with uric acid, a small stone after stone in the blood return to the residue dissolved so that the blood uric acid increased rapidly, if not promptly and effectively to drop acid treatment, after the majority of people in the non-operative joint acute arthritis Some multi-joint alternating repeated incidence. At this point in addition to eat food rich in purine, down uric acid to increase the amount of drugs, and for seven days after the previous day to a daily service 1 ~ 3 mg colchicine, can significantly reduce acute arthritis. ② strengthen hypertension, coronary heart disease, diabetes, kidney disease and other diseases related to the treatment of these diseases under control.