全髋关节置换术在活动期髋关节结核治疗中的近期疗效观察  

Short-term clinical results of total hip arthroplasty in active tuberculosis of hip

作　　者：缪晓刚[1] 吴超 赵巍[1] 哈巴西[1] 阿里木[1] 王利[1] 袁宏[1] 

机构地区：[1]新疆维吾尔自治区人民医院骨一科,乌鲁木齐830001 [2]新疆维吾尔自治区石化总医院,乌鲁木齐830054

出　　处：《中华关节外科杂志（电子版）》2013年第5期29-31,共3页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的探讨在活动期髋关节结核治疗中行人工全髋关节置换术治疗的近期疗效。方法本组12例患者自2006年3月至2010年3月，年龄24～61岁，平均（42．5±1．0）岁。其中临床上均有疼痛，血沉偏高。其中3例有髋部皮肤窦道，手术时候皮肤完好。均采用髋关节前外侧入路行人工全髋关节置换术，8例获得随访，随访观察6～24个月，平均（8．0±0．5）月，Harris评分进行术后临床评定，x线检查观察假体周围有无松动，结核有无复发，评价本组患者的治疗效果。结果本组患者术后均无切口感染、神经血管损伤、假体脱位、松动和下肢深静脉血栓形成，无结核复发髋关节。术前Harris评分20—38分，平均（25．0±2．0）分；术后Harris评分59～90分，平均（76．4±0．4）分，手术前后Harris评分有统计学差异（P〈0．05）。结论在系统治疗结核基础上行人工全髋关节置换术，在活动期髋关节结核治疗中的近期疗效是可以肯定的，可明显改善髋关节的活动功能，缓解疼痛，提高患者的生活质量。Objective To evaluate the curative effects of the total hip arthroplasty （THA） in patients with active tuberculosis of the hip. Methods There were 12 patients with active tuberculosis of the hip accepting total hip arthroplasty from March, 2006 to March, 2010. The age was 24 to 61 years old, （42.5 ± 1.0） years in average. They all had pain and raised ESR. There were three cases with sinus on the skin, but before the operation the skin had healed. All patients underwent total hip arthroplasty by anterolateral approach. Eight cases were followed up for 6-24 months, （ 8.0 ± 0.5 ） months in anverage. Post-operative Harris score and X-ray were taken to evaluate the curative effects of the THA. Results Incision infection, DVT, injury of nerve or vessels were not found in all the patients. There was also no dislocation, aseptic loosening or fracture of prosthesis. Preoperative Harris Hip Score was 20 to 38, （25.0 ± 2.0） in average. The post-operative Harris score was 59 to 90, （ 76.4 ± 0.4 ） in average. Conclusion The short-term clinical results showed that THA is effective in the treatment of active tuberculosis of the hip. THA can significantly relieve the pain, and improve the joint function and the living condition of the patients.

关 键 词：关节成形术 置换 髋 结核 治疗 活动期 

分 类 号：R687.4[医药卫生—骨科学]