Purpose. To explore the technique of surgical treatment of hand and foot gout stone by using 3D CT reconstruction images and influence factors on prognosis. Method. 48 cases of hand and foot gout were treated surgically and retrospective analyzed. Before operation, we used 3D CT reconstruction images to check the accurate site and amount of uric acid (white chalk foam) deposition. Different surgical methods were applied depending on the different deposition site of urine acid stone. The frequency of gout attack and blood uric acid was compared before and after surgery. Patients were followed up to observe the recovery and recurrence and then analyzed the reason of unsuccessful healing. Result. Sutures were removed 2 weeks after operation in all cases. The frequency of gout attack and blood uric acid of patients 3 months after operation was lower than those before operation, and the differences were statistically significant. Follow-up ranged from 1 to 3 years, with an average of 1.8 years. Three cases were not followed up. The remaining 45 cases were healed in the first stage. 40 cases had improved joint function, increased range of motion, and relieved discomfort after movement. 5 cases had no improvement in joint function after operation, and 3 of them had gout stone recurrence (nonoperative area) and were treated by second hospital operation. Conclusion. Surgical treatment of gout stone in hand and foot under the guidance of three-dimensional CT reconstruction image can effectively alleviate the local symptoms of gout stone and improve the function of hand and foot. Deep tissue can be thoroughly washed by the pressure of pulse gun after resection of the lesion, which can reduce the incidence of gout stone. Malnutrition, hypoproteinemia, and residual urine acid in the wound are the main reasons for unsuccessful healing.

中文翻译：

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手足痛风石的手术治疗及预后影响因素

目的。探讨利用3D CT重建图像手术治疗手足痛风结石的技术及影响预后的因素。方法。对48例手足痛风患者进行手术治疗并进行回顾性分析。术前利用3D CT重建图像检查尿酸（白色粉笔泡沫）沉积的准确部位和量。根据尿酸性结石沉积部位的不同，采用不同的手术方法。比较手术前后痛风发作频率和血尿酸。对患者进行随访，观察康复情况和复发情况，分析治愈不成功的原因。结果。所有病例均在术后 2 周拆线。患者术后3个月痛风发作频率、血尿酸均低于术前，差异有统计学意义。随访时间1～3年，平均1.8年。其中三起案件没有得到后续跟进。其余45例一期治愈。40例关节功能改善，活动范围增大，运动后不适减轻。5例术后关节功能无改善，其中3例痛风结石复发（非手术区），经二院手术治疗。结论。在三维CT重建图像指导下手术治疗手足痛风结石，可以有效缓解痛风结石的局部症状，改善手足功能。病灶切除后，脉冲枪的压力可彻底冲洗深层组织，可减少痛风结石的发生。营养不良、低蛋白血症、伤口内残留尿酸是愈合不成功的主要原因。