慢性自身免疫性疾病患者初次人工全髋关节置换术后中远期疗效  

MIDDLE-AND LONG-TERM EFFECTIVENESS OF PRIMARY TOTAL HIP ARTHROPLASTY FOR PATIENTS WITH CHRONIC AUTOIMMUNE INFLAMMATORY DISEASE

作　　者：康焱[1] 张紫机[1] 张志奇[1] 杨子波[1] 傅明[1] 盛璞义[1] 何爱珊[1] 徐栋梁[1] 廖威明[1] 

机构地区：[1]中山大学附属第一医院关节外科,广州510080

出　　处：《中国修复重建外科杂志》2012年第9期1033-1036,共4页Chinese Journal of Reparative and Reconstructive Surgery

基　　金：国家自然科学基金资助项目(81171709)~~

摘　　要：目的探讨慢性自身免疫性疾病患者行初次人工全髋关节置换(total hip arthroplasty,THA)术后的中远期疗效。方法 1990年1月-2006年6月,对42例(51髋)慢性自身免疫性疾病患者行初次THA。男15例(18髋),女27例(33髋);年龄22～70岁,平均36.9岁。左侧29髋,右侧22髋。其中系统性红斑狼疮11例(13髋),类风湿性关节炎16例(22髋),强直性脊柱炎15例(16髋)。髋关节置换原因:股骨头缺血性坏死26例(34髋),髋关节僵硬15例(16髋),股骨颈骨折1例(1髋)。术前髋关节Harris评分为(32.49±9.50)分;简明健康调查量表(SF-36量表)中体能方面总分(physical component summary,PCS)为(25.53±4.46)分,精神方面总分(mental component summary,MCS)为(42.28±6.27)分。结果术后患者切口均Ⅰ期愈合。42例患者均获随访,随访时间5～21年,平均9.1年。末次随访时Harris评分为(89.25±8.47)分;SF-36量表评分PCS为(51.35±4.28)分,MCS为(55.29±8.31)分;与术前比较差异均有统计学意义(P<0.05)。术后并发症包括跛行(4例)、假体脱位(2例2髋)、假体周围骨折(1例1髋)、假体无菌性松动(2例2髋)以及异位骨化(3例3髋)。结论对于慢性自身免疫性疾病引起的髋关节功能丧失,采用THA治疗可获得较好疗效。Objective To evaluate the middle-and long-term effectiveness of primary total hip arthroplasty（THA）in patients with chronic autoimmune inflammatory diseases.Methods Between January 1990 and June 2006,42 patients（51hips） with chronic autoimmune inflammatory diseases underwent THA.There were 15 males（18 hips） and 27 females（33 hips）with an average age of 36.9 years（range,22-70 years）.The locations were the left side in 29 hips and the right side in 22 hips.Of42 cases,there were 11 cases of systemic lupus erythematosus（13 hips）,16 cases of rheumatoid arthritis（22 hips）,and 15 casesof ankylosing spondylitis（16 hips）.The causes of THA included avascular necrosis of the femoral head in 26 cases（34 hips）,ankylosis of the hip in 15 cases（16 hips）,and fracture of the femoral neck in 1 case（1 hip）.The Harris score was 32.49 ± 9.50.The physical component summary（PCS） and mental component summary（MCS） of short form 36 health survey scale（SF-36）scores were 25.53 ± 4.46 and 42.28 ± 6.27,respectively.Results All incisions healed primarily.All 42 patients were followedup 5-21 years（mean,9.1 years）.At last follow-up,the Harris score was 89.25 ± 8.47;PCS and MCS of the SF-36 were 51.35 ± 4.28and 55.29 ± 8.31,respectively;and significant diff erences in the scores were found between pre-and post-operation（P 0.05）.Complications included limp（4 cases）,prosthesis dislocation（2 cases,2 hips）,periprosthetic fracture（1 case,1 hip）,asepticloosening（2 cases,2 hips）,and ectopic ossification（3 cases,3 hips）.Conclusion THA seems to be a good choice for patientswith chronic autoimmune inflammatory diseases.

关 键 词：人工全髋关节置换 慢性自身免疫性疾病 关节功能重建 

分 类 号：R687.4[医药卫生—骨科学]