人工髋关节置换治疗严重髋关节疾病  

Artificial hip joint replacement for the treatment of severe hip diseases

作　　者：李广伟[1,2] 

机构地区：[1]郑州大学公共卫生学院,河南省郑州市450001 [2]郑州市第二人民医院骨二科,河南省郑州市450006

出　　处：《中国组织工程研究》2013年第13期2297-2304,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:终末期髋关节疾病施行人工全髋关节置换难度大,涉及面多,包括置换入路、置换中截骨、假体的植入、类型的选择等,专家学者各不相同,意见不统一,争议较多。目的:探讨人工全髋关节置换治疗终末期髋关节疾病的方法及临床效果。方法:回顾性分析52例(57髋)人工髋关节置换患者,进行长期随访,随访时间14-86个月,平均随访时间为27个月。随访并记录置换前后(末次随访时)的目测类比评分、Harris评分,分析比较置换前后评分并对结果进行统计学分析。结果与结论:52例患者中目测类比评分由置换前的(7.0±1.2)分降至置换后的(2.0±0.7)分,Harris评分从置换前的(35.9±5.4)分增加到末次随访的(89.7±3.1)分,与置换前相比差异有显著性意义(P<0.05)。52例患者置换后均可扶拐或助行器下地行走,3个月后能独立行走,生活自理,X射线评估无假体松动,治疗效果满意。说明精心的置换前准备、科学严谨的操作技术可预防髋部假体松动、感染、疼痛等并发症,置换后科学正确的康复锻炼是减少置换后疼痛、功能最大程度恢复的重要措施。BACKGROUND： Applying artificial hip joint replacement for the treatment of end-stage hip disease is difficult and involves multi-aspects, including the surgical approach, intraoperative osteotomy, prosthesis implantation and selection of type, There are a lot of controversies due to different scholarly opinions.OBJECTIVE： To explore the methods and clinical effects of the artificial hip joint replacement in the treatment of end-stage hip disease.METHODS： Retrospective analysis of 52 patients （57 hips） receiving artificial hip joint replacement was performed based on a long-term follow-up. The follow-up time was 14-86 months, 27 months in average. The preoperative and postoperative （last follow-up） visual analogue scale score and Harris hip score were recorded, analyzed and compared, and the results were statistically analyzed.RESULTS AND CONCLUSION： The visual analogue scale score in 52 patients was decreased from preoperative （7.0±1.2） points to postoperative （2.0±0.7） points. Harris score was increased from preoperative （35.9±5.4） points to the last follow-up （89.7±3.1） points. The difference was statistically significant when compared with that before operation （P 〈 0.05）. All the 52 patients after surgery could walk with crutches or walker ambulation, and all of them could be able to walk independently and take self-care after 3 months. X-ray assessment showed no loosening of the prosthesis, and achieved satisfactory results. Careful preoperative preparation and scientific and rigorous operation can prevent the hip prosthesis loosening, infection and pain after operation. Rehabilitation exercise after surgery is an important measure to reduce the postoperative pain and recover the function to the maximum extent.

关 键 词：骨关节植入物 人工假体 人工髋关节 骨水泥 成形 假体松动 置换后疼痛 置换后感染 置换后并发症 目测类比评分 Harris评分 假体置换 骨关节植入物图片文章 

分 类 号：R318[医药卫生—生物医学工程]