痛风石性痛风相关的腕管综合征及屈肌腱受累：一项系统性综述。
完整摘要 · 中文译文
背景：痛风石性痛风是继发性腕管综合征（CTS）一种不常见但具有临床重要性的病因，其病变范围从弥漫性屈肌腱鞘炎到肌腱内破坏及正中神经直接受累不等。 方法：检索PubMed/MEDLINE、Scopus和Web of Science核心合集，截止日期为2026年7月23日，并以Google Scholar、出版商页面核实及引文检索作为补充。凡明确将CTS或腕部正中神经病变归因于痛风、痛风石或单钠尿酸盐沉积的人体原始报告均符合纳入标准。两名评价者独立筛选记录。57篇报告（27篇完整/详细来源及30篇有限临床来源）构成主要综合证据，并接受设计相适应的Joanna Briggs研究所质量评价；12篇书目信息或翻译受限的报告作为历史辅助证据保留。原始报告另经事后按因果确定性进行分类。 结果：在478条数据库记录中，筛选了302条唯一记录，最终纳入69篇规范报告。57篇报告的主要综合证据包括44篇病例报告或临床影像报告、12篇病例系列和1项非随机对照研究，至少代表120例患者、152个CTS患腕和146个归因于痛风的患腕。117例患者可报告性别，其中111例（94.9%）为男性。因果确定性为1级（直接局部确认）者41篇，2级（解剖学支持）者5篇，3级（报告层面明确归因）者11篇。事后敏感性分析保留1级+2级（n=46），随后保留Ti 仅第1章（n = 41）并未改变主要的定性解释。开放性减压联合病灶处理是最常报告的手术方式，但证据仍不足以确定首选的肌腱处理方案。JBI研究结果按设计类型报告；481条条目级判断仅作为审计总数保留。 结论：对于非典型、急性、严重、复发性、双侧或与肿块相关的腕管综合征（CTS），应考虑痛风。在外科治疗的报告中，减压常与痛风石及肌腱病变的个体化管理相结合。证据主要为基于病例的、产生假设性的证据，不足以确定经过验证的治疗路径或首选的肌腱处理方案。
完整摘要 · 英文原文
BACKGROUND: Tophaceous gout is an uncommon but clinically important cause of secondary carpal tunnel syndrome (CTS), with lesions ranging from diffuse flexor tenosynovitis to intratendinous destruction and direct median nerve involvement. METHODS: PubMed/MEDLINE, Scopus, and Web of Science Core Collection were searched through 23 July 2026, supplemented by Google Scholar, publisher-page verification, and citation searching. Human primary reports explicitly attributing CTS or wrist-level median neuropathy to gout, tophus, or monosodium urate deposition were eligible. Two reviewers independently screened records. Fifty-seven reports (27 complete/detailed and 30 limited clinical sources) formed the primary synthesis and underwent design-appropriate Joanna Briggs Institute appraisal; 12 bibliographic or translation-limited reports were retained as historical ancillary evidence. Primary reports were additionally classified post hoc by causal certainty. RESULTS: Of 478 database records, 302 unique records were screened, and 69 canonical reports were included. The 57-report primary synthesis comprised 44 case reports or clinical-image reports, 12 case series, and one nonrandomized comparative study, representing at least 120 patients, 152 CTS wrists, and 146 gout-attributable wrists. Sex was reportable for 117 patients, of whom 111 (94.9%) were male. Causal certainty was Tier 1 (direct local confirmation) in 41 reports, Tier 2 (anatomically supported) in 5, and Tier 3 (explicit report-level attribution) in 11. Post hoc sensitivity analyses retaining Tier 1 + 2 (n = 46) and then Tier 1 only (n = 41) did not change the principal qualitative interpretations. Open decompression with lesion treatment was the most frequently reported operative pattern, but evidence remained insufficient to determine a preferred tendon procedure. JBI findings are reported by design; 481 item-level judgments are retained only as an audit total. CONCLUSION: Gout should be considered in atypical, acute, severe, recurrent, bilateral, or mass-associated CTS. In surgically treated reports, decompression was commonly combined with individualized management of tophaceous and tendon disease. The evidence is predominantly case-based and hypothesis-generating and is insufficient to define a validated treatment pathway or preferred tendon procedure.