屈肌腱痛风石导致的复发性腕管综合征：一例报告
A repeated carpal tunnel syndrome due to tophaceous gout in flexor tendon: A case report.
作者信息
Lu Hui, Chen Qiang, Shen Hui
机构信息
Department of Hand Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, P.R. China Department of Hand Surgery, Zhejiang Province People's Hospital, Hang Zhou, Zhejiang Province, P.R. China.
出版信息
Medicine (Baltimore). 2017 Mar;96(9):e6245. doi: 10.1097/MD.0000000000006245.
RATIONALE
Gouty tophi is a rare cause of CTS. We first report a unique case of repeated CTS with gouty tophi in flexor tendon. In the previous literature, the symptoms cases of CTS were gradually increased.
PATIENT CONCERNS
We report a 44-year-old male porter presented with mass on his left distal forearm combined a repeated carpal tunnel syndrome for 5 years. He felt numbness in fingers and his left palmar. The CTS symptoms had been eased through rest and dugs medication. It recurred twice.
DIAGNOSES
Monosodium urate crystal deposits were found in surgery. Histologic findings confirmed the diagnosis of gout.
INTERVENTIONS
We removed partial of gouty tophus and retained the integrity of the tendon.
OUTCOMES
Two years after the surgery, the patient had not experienced any symptom recurrence.
LESSONS
Early diagnosis and control of gout are necessary to avoid irreversible complications. The surgery combined with decreasing trioxypurine treatment can improve the treatment outcome of gouty tophus.
理论依据
痛风石是腕管综合征（CTS）的罕见病因。我们首次报告了一例屈肌腱中伴有痛风石的复发性腕管综合征的独特病例。在以往文献中，腕管综合征的症状病例逐渐增多。
患者情况
我们报告一名44岁男性搬运工，左前臂远端有肿物，合并复发性腕管综合征5年。他手指及左手掌有麻木感。腕管综合征症状经休息及药物治疗有所缓解，复发过两次。
诊断
手术中发现尿酸钠晶体沉积。组织学检查结果确诊为痛风。
干预措施
我们切除了部分痛风石，保留了肌腱的完整性。
结果
术后两年，患者未出现任何症状复发。
经验教训
早期诊断和控制痛风对于避免不可逆并发症很有必要。手术联合降低三氧嘌呤治疗可改善痛风石的治疗效果。
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