布鲁杆菌性髋关节炎与股骨头坏死关系的探讨  

Relationship between brucellosis arthritis of the hip and femoral head necrosis

作　　者：于占水[1] 程大伟[1] 陈雪英[1] 谢福杰[1] 李福兴[1] 

机构地区：[1]黑龙江省农垦总局总医院布鲁杆菌病科,哈尔滨150088

出　　处：《中华地方病学杂志》2014年第1期93-95,共3页Chinese Journal of Endemiology

摘　　要：目的探讨布鲁杆菌性髋关节炎与股骨头坏死的关系。方法以2007年8月至2013年8月黑龙江省农垦总局总医院确诊并住院治疗的16例布鲁杆菌病（布病）并发股骨头坏死患者作为观察对象，回顾性调查分析其住院病例资料。观察内容包括患者的一般情况、临床症状体征、影像学检查、病理检查、治疗方法及疗效等。结果16例患者均有明确的髋关节炎及股骨头坏死临床表现：髋关节疼痛，活动受限，“4”字试验阳性，或跛行或卧床，患肢肌肉萎缩。影像学检查：电子计算机X线断层摄影（CT）显示股骨头囊状改变，变形塌陷；核磁共振成像（MRI）显示Tl加权像呈低信号，，12加权像呈高信号，髋关节内可见增生的肉芽软组织影。病理学检查：股骨头大部分骨组织坏死、溶解、骨细胞消失，少许骨细胞存在，部分纤维组织增生。按布鲁杆菌病治疗原则采用抗生素治疗，效果明显。结论布鲁杆菌性髋关节炎与股骨头坏死存在因果关系。因此，早期积极有效治疗布病性髋关节炎，是阻止发生股骨头坏死的关键。Objective To investigate the relationship between brucellosis arthritis of the hip and femoral head necrosis. Methods In August 2007 to August 2013, 16 diagnosed and hospitalized patients with brucellosis complicated with femoral head necrosis in Heilongjiang Land Reclamation Bureau General Hospital were chosen as the objects of observation, and the patients＇ hospitalization information was analyzed retrospectively. Patients＇ medical records were investigated and analyzed. Observations included general condition of the patient, clinical symptoms and signs, imaging, pathology, treatment and curative effect. Results All the 16 patients had definite clinical manifestations of hip arthritis and femoral head necrosis including hip pain, limited mobility, positive ＂4＂ test, limp or bedridden, and sick limb muscle atrophy. Imaging examination： X-ray computer tomography （CT） showed cystic change and deformation collapse of femoral head. Magnetic resonance imaging（MRI） showed low signal on weighted T1 images, high signal on weighted T2 and soft tissue granulation hyperplasia could be seen in the hip joint. Pathological examination： most femoral bone tissue necrosis, dissolved, bone cells disappeared, a few bone cells present, and some fibrous tissue hyperplasia. Patients were treated with antibiotics according to the treatment principles of brucellosis, and the effect was obvious. Conclusions There is a causal relationship between brucellosis arthritis of the hip and femoral head necrosis. Therefore, positive and effective treatment of brucellosis arthritis of the hip in the early stages is crucial to prevent the occurrence of femoral head necrosis.

关 键 词：布鲁杆菌病 股骨头坏死 骨关节炎 髋 

分 类 号：R516.7[医药卫生—内科学]