髋关节骨性关节炎的分级治疗探讨  

Grading treatment of hip osteoarthritis

作　　者：赵铁军[1] 张洪美[1] 陈卫衡[1] 荆林[1] 孙刚[1] 顾力军[1] 张淳[1] 尹天[1] 

机构地区：[1]中国中医科学院望京医院骨关节一科,北京100102

出　　处：《中国骨伤》2010年第9期665-667,共3页China Journal of Orthopaedics and Traumatology

摘　　要：目的:探讨与评价关节内注射玻璃酸钠、髋关节镜及全髋关节置换治疗不同严重程度髋关节骨性关节炎的临床效果。方法:2004年6月至2008年8月收治髋关节骨性关节炎89例(105髋),男33例,女56例;年龄为30～72岁,平均51.8岁;病程3～360个月,平均58.7个月。所有患者均有髋痛及髋关节活动受限症状。依据髋关节骨性关节炎严重性指数评分(ISOA)及Kellgren-Lawrance(K-L)放射线分级标准进行分组治疗,对治疗前后的Harris评分进行分析。结果:随访时间3～58个月,依据Harris标准进行功能评分:轻度髋关节骨性关节炎放射线Ⅰ级患者术前平均(70.50±4.62)分,术后平均(91.75±4.01)分;Ⅱ级患者术前平均(70.15±3.79)分,术后平均(82.18±3.92)分。中度髋关节骨性关节炎放射线Ⅲ级患者术前平均(57.12±2.19)分,术后平均(89.94±1.13)分。重度髋关节骨性关节炎放射线分级Ⅳ级患者术前平均(48.63±2.21)分,术后平均(90.76±1.14)分;髋关节骨性关节炎非常严重放射线分级Ⅳ级患者术前平均(42.67±3.17)分,术后平均(91.97±2.24)分;极其严重放射线分级Ⅳ级患者术前平均(36.46±2.96)分,术后平均(82.69±1.19)分。各组治疗前后结果均有差异,治疗后评分升高。结论:通过髋关节骨性关节炎严重程度的分级,采用相对应的治疗方法,对轻、中、重度的髋关节骨性关节炎均可获得良好的临床效果。Objective：To investigate therapeutic effects of intra articular injection of sodium hyaluronate,arthroscopy and total hip replacement for the treatment of different severity hip osteoarthritis.Methods：Eighty nine patients were treated with the three methods from June 2004 to August 2008.There were 33 males and 56 females,ranging in age from 30 to 72 years,averaged 51.8 years.The disease course ranged from 3 to 360 months,with a mean of 58.7 months.All the patients had hip pain and limited movement of hip joint.The patients were treated according to ISOA score and Kellgren-lawrance （K-L）grades of hip osteoarthritis.The preoperative and postoperative Harris scores were compared.Results：After the operation,83 patients were followed up,and the duration ranged from 3 to 58 months.The Harris scores results：the patients with slight hip osteoarthritis and K-L gradeⅠgot an averaged preoperative score of （70.50±4.62） and postoperative score of （91.75±4.01）;the patients with slight hip osteoarthritis and K-L gradeⅡgot an averaged preoperative score of （70.15±3.79） and postoperative score of （82.18±3.92）.The patients with moderate hip osteoarthritis and K-L grade Ⅲ got an averaged preoperative score of （57.12±2.19） and postoperative score of （89.94±1.13）score.The patients with serious hip osteoarthritis and K-L grade Ⅳ got an averaged preoperative score of（48.63±2.21） and postoperative score of （90.76±1.14）;the patients with very serious hip osteoarthritis and K-L grade Ⅳ got an averaged preoperative score of（42.67±3.17） and postoperative score of（91.97±2.24）;the patients with extremely serious hip osteoarthritis and K-L gradeⅣ got an averaged preoperative score of （36.46±2.96） and postoperative score of（82.69±1.19）.There were significant differences in scores of all groups before and after treatment.Con-clusion：The hip osteoarthritis should be treated according to its serious degree such as slight,moderate and severe,as well as based on it

关 键 词：骨性关节炎 髋 注射 关节内 关节镜手术操作 关节成形术 置换 髋 临床方案 

分 类 号：R684.3[医药卫生—骨科学]