单次静脉滴注唑来膦酸对全髋关节置换术后假体早期移位及临床疗效的影响  

Effect of single intravenous infusion of zoledronic acid on early displacement of prosthesis after total hip arthroplasty

作　　者：王巍[1] 郭金库 何飞熊[1] 吴盼 洪胜坤 金乾坤[1] 付志强 WANG Wei;GUO Jinku;HE Feixiong(Department of Orthopedics,Quzhou People’s Hospital,Quzhou 324000,China)

机构地区：[1]衢州市人民医院骨科

出　　处：《浙江医学》2019年第11期1143-1146,共4页Zhejiang Medical Journal

基　　金：衢州市科技计划项目(2015N1010825)

摘　　要：目的评估4mg唑来膦酸单次静脉滴注对股骨头坏死患者全髋关节置换术后早期假体移位及临床疗效的影响。方法选取接受全髋关节置换术的股骨头坏死患者30例,采用随机数字表法分为试验组和对照组各15例。术后1d,试验组患者静脉滴注唑来膦酸4mg(溶于100ml 0.9%氯化钠注射液);对照组患者静脉滴注100ml 0.9%氯化钠注射液。定期通过CT薄层扫描(层厚0.3mm)进行随访,比较两组患者假体移位距离;监测两组患者骨代谢指标和骨密度变化情况并作比较;采用Harris评分系统比较两组患者的髋关节功能恢复情况。结果术后2年,两组患者股骨柄下沉距离比较差异无统计学意义(P>0.05),但髋臼杯上移及内移距离比较差异均有统计学意义(均P<0.05)。两组患者术后7周、6个月、1年I型胶原氨基末端肽比较差异均有统计学意义(均P<0.05)。两组患者所有时点骨钙素比较差异均有统计学意义(均P<0.05)。两组患者术后7周、6个月、1年、2年腰椎骨密度比较差异均有统计学意义(均P<0.05)。两组患者术后2年Harris评分均较治疗前明显增加,试验组Harris评分明显高于对照组,差异均有统计学意义(均P<0.05)。结论单次使用唑来膦酸可增加非骨水泥假体稳定性,提高股骨头坏死患者全髋置换术后的临床疗效。Objective To evaluate the effect of single intravenous infusion of zoledronic acid on early displacement of prosthesis after total hip arthroplasty.Methods Thirty patients with femoral head necrosis undergoing total hip arthroplasty were randomly divided into two groups with 15 cases in each group.Patients in study group received intravenous infusion of 4 mg zoledronic acid 1 d after operation,while infusion of saline was given to control group.Thin layer CT scanning(0.3 mm thick)was performed after surgery and the prosthetic shift was observed.The Harris hip score and bone metabolic index changes were compared between two groups.Results There were significant differences in the average internal displacement of the acetabular cup and cephalic(upper)displacement at the last follow-up between the study group and the control group(both P<0.05).There were significant differences in NTX at 7 weeks,6 months and 1 year after surgery(all P<0.05);in OC at all follow-up time(all P<0.05);and in bone mineral density at 7 weeks,6 months,1 year and 2 years after surgery(all P<0.05)between two groups.The Harris scores were significantly increased 2 years after surgery in both groups,but it increased more markedly in study group(all P<0.05).Conclusion Single intravenous infusion of zoledronic acid can improve the stability of bone cement prosthesis,improve the clinical efficacy in patients with femoral head necrosis after total hip arthroplasty.

关 键 词：唑来膦酸 全髋关节置换术 数字模型 假体移位 

分 类 号：R687.4[医药卫生—骨科学]