髋关节假体置换术后并发症及应对策略  

Review of the complications and coping treatment strategies after hip prosthesis replacement

作　　者：刘威[1] 刘斌[1] 朱加亮[2] 

机构地区：[1]国家食品药品监督管理局医疗器械技术审评中心,北京100044 [2]解放军总医院第一附属医院骨科,100048

出　　处：《中国骨与关节杂志》2012年第3期304-308,共5页Chinese Journal of Bone and Joint

摘　　要：随着人口老龄化,骨质疏松导致股骨颈骨折成为老年人残疾的常见原因,而人工髋关节假体置换术已经成为缓解疼痛、矫正畸形和恢复下肢功能的有效方法.人工髋关节应用于临床多年,因术后并发症的发生导致治疗失败的病例也逐渐增多,给患者带来了额外的痛苦.本文回顾性分析近些年的国内外相关文献,对髋关节假体置换术后常见的并发症及其相应的预防和治疗措施进行综述.With the aggravation of the population ageing, femoral neck fractures caused by osteoporosis became a common cause of disability in the elderly. The wide application of artificial hip joint improved quality of life in these elderly patients. The efficacy of hip prosthesis replacement depended on patient condition, surgical technique, prosthesis design and material, most importantly, prevention and treatment of the complications. However, there were relevant complications after hip prosthesis replacement, including early complications, such as joint infection （superficial and deep infection）, joint dislocation, periprosthetic fractures, deep vein thrombosis, etc and late complications, such as prosthetic loosening and heterotopic ossification, etc. Due to these complications, the patients suffered more, the medical cost rose and the surgical effect got worse. In order to assure operational security and improve clinical efficacy, in recent years, scholars at home and abroad focused on the causes of complications and the development of preventive and therapeutic methods, which effectively reduced the incidence of complications and the harm to patients because of the complications. Such measures were taken： apply antibiotic bone cements in operation to prevent deep infection after replacement; Modify the operation approach to prevent postoperative dislocation of prosthesis; Apply osteoplastic medicine to prevent prosthetic loosening under sterile condition; Take rivaroxaban orally to prevent deep venous thrombosis of the lower extremity; Explore new therapeutic modes to prevent heterotopic ossification, etc. Related literatures about the prevention and treatment of the complications after hip prosthesis replacement at home and abroad in recent years were retrospectively analyzed, and the causes for the common complications after hip prosthesis replacement and relevant preventive and therapeutic methods were reviewed.

关 键 词：人工髋关节假体置换术 术后并发症 治疗失败 人口老龄化 股骨颈骨折 骨质疏松 缓解疼痛 下肢功能 

分 类 号：R687.4[医药卫生—骨科学]