髋关节置换术治疗髋部疾病合并帕金森病的疗效分析  

Efficacy analysis on hip replacement for hip-joint diseases with Parkinson disease

作　　者：孙启才[1] 茹选良[1] 夏燕飞[1] 刘小利[1] 宋柏杉[1] 乔松[1] 严世贵[2] 王祥华[2] 

机构地区：[1]浙江医院骨科,浙江杭州310013 [2]浙江大学医学院附属第二医院,浙江杭州310009

出　　处：《中国骨伤》2017年第12期1102-1106,共5页China Journal of Orthopaedics and Traumatology

基　　金：浙江省医药卫生一般研究计划项目(编号:2014KYB010;2012KYB007);浙江省中医药科技计划项目(编号:2017ZB003);浙江省教育厅项目(编号:Y201534707)~~

摘　　要：目的 :探讨髋关节置换术在髋部疾病合并帕金森病患者中的临床疗效进行分析。方法 :自2011年12月至2016年12月,回顾性分析采用髋关节置换术治疗18例髋部疾病合并帕金森疾病的患者,男8例,女10例;年龄59~87岁,平均71岁。其中3例为发育性髋关节发育不良,3例为股骨头坏死,12例为股骨颈骨折。患者术前均有明显疼痛,行走能力受限。观察患者术后并发症情况,并采用Harris评分比较手术前后髋关节功能变化。结果:术后患者伤口愈合良好,疼痛均较术前明显减轻或消失,髋关节功能明显改善。18例患者均获得随访,时间1~3年,平均2.3年。末次随访时,14例恢复自由行走,2例需要手杖帮助下行走,1例助行器协助行走,1例死亡。18例中,2例出现脱位,其中1例脱位患者于术后3个月因心肺疾病死亡,此外,有4例活动后出现轻微疼痛。术前Harris评分(41.7±1.4)分别与术后6个月(80.1±5.4)和末次随访(83.4±2.1)比较差异有统计学意义(P<0.05),其中优10例,良4例,可1例,差2例。结论:人工关节置换术在髋部疾病合并帕金森病患者中的应用是一种安全有效的治疗方法,具有并发症少、功能恢复快的优点。Objective：To explore clinical efficacy of hip replacement for hip joint diseases with Parkinson disease. Methods：From December 2011 to December 2016,18 patients with hip-joint diseases with Parkinson disease treated by hip replacement,including 8 males and 10 females aged from 59 to 87 years old with an average of 71 years old. Among them,3 cases were developmental dysplasia of hip,3 cases were femoral head necrosis and 12 cases were femoral neck fracture. All patients manifested with obvious pain and limitation of stepping ability. Postoperative complications were observed and Harris score were used to compare hip joint function after operation. Results：The incision were healed well,and pain were alleviated or disappeared,and hip joint function were improved. Eighteen patients were followed up from 1 to 3 years with an average of2.3 years. At the latest follow up,14 cases recovered freedom-walk,2 cases could walk with walking stick,1 case could walk with walking aid and 1 case was died. Among 18 patients,2 cases were occurred dislocation,and 1 case were died for cardiac disease at 3 months after operation. Four patients were occurred slight pain. There were significant differences in Harris scores among preoperative（41.7±1.4）,6 months after operation（ 80.1±5.4）and the final follow-up（ 83.4±2.1）,and 10 cases got excellent result,4 good,1 fair and 2 poor. Conclusion：Application of hip replacement for hip joint diseases with Parkinson disease is a safe and effective clinical therapy,and has advantages of less complications and rapid recovery of hip joint function.

关 键 词：髋关节置换术 全 帕金森病 术后并发症 

分 类 号：R687.4[医药卫生—骨科学]