全髋关节置换术治疗尿毒症合并股骨颈骨折围手术期处理及疗效观察  

Perioperative Management and Effect Observation of Total Hip Replacement in Patients with Femoral Neck Fracture in Uremia

作　　者：雒仁凯 邱红明[2] LUO Ren-kai;QIU Hong-ming(Shandong University of Traditional Chinese Medicine,Jinan 250000,China;Department of Orthopedics,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学,济南250355 [2]山东中医药大学附属医院关节骨科,济南250014

出　　处：《江西中医药大学学报》2022年第2期49-52,共4页Journal of Jiangxi University of Chinese Medicine

摘　　要：目的:探讨尿毒症合并股骨颈骨折患者行人工全髋关节置换的围手术期处理及临床疗效观察。方法:回顾性分析2015年10月—2019年11月首次就诊于山东中医药大学附属医院关节骨科的22例尿毒症合并股骨颈骨折患者病历资料,其中男10例、女12例,年龄在42~75岁,平均年龄(63.7±8.0)岁,关节置换方式均采用后外侧入路的全髋关节置换术,采用假体均为德国LINK生物型全陶瓷或半陶瓷假体。出院后门诊随访拍摄髋关节正位片并记录患者的疼痛VAS评分、髋关节Harris评分及并发症等情况。结果:22例患者术后获8~36个月随访,平均随访(17.5±7.1)个月。患者疼痛VAS评分由术前的平均(7.1±1.8)分降至末次随访的(1.7±1.2)分,差异有统计学意义(P<0.05);髋关节Harris评分由术前的平均(29.5±18.1)分升至末次随访的(89.6±7.6)分,差异有统计学意义(P<0.05)。除1例术后发生肌间静脉血栓外,其余均无假体感染、松动,无下肢深静脉血栓、假体周围骨折等并发症发生。结论:无严重骨质疏松、无明显手术禁忌的尿毒症合并股骨颈骨折患者,通过围手术期的谨慎、正确处理,采用生物型全髋关节置换术是安全可行的,术后可有效减轻疼痛,恢复髋关节功能,提高患者生活质量。[Abstrct]Objective:To investigate the perioperative management and clinical effect of total hip replacement in patients with uremia combined with femoral neck fracture.Methods:Retrospective analysis was performed on 22 patients with uremia complicated with femoral neck fracture who first visited the orthopaedic department of the affiliated hospital of shandong university of traditional Chinese medicine from October 2015 to November 2019,10 of the male,and 12 of the female,the average age(63.7±8.0),joint replacement method adopts the posterolateral approach of total hip replacement,the prosthesis were all German LINK biological type ceramic or ceramic prosthesis.In the Outpatient followup after discharge,the orthotopic hip radiography was taken and the patients’VAS score,Hip Harris score and complications were recorded.Results:Twenty-two patients were followedup for an average of(17.5±7.1)months(8-36 months).Postoperative VAS score decreased from(7.1±1.8)points preoperatively to(1.7±1.2)points in the last follow-up,with statistically significant difference(P<0.05).Harris score of hip joint increased from(29.5±18.1)points to(89.6±7.6)points(P<0.05).In this group,except for 1 case of postoperative intermuscular vein thrombosis,no other complications such as infection and loosening of prosthesis,deep vein thrombosis of lower limbs,and periprosthesis fracture occurred.Conclusion:For patients with uremia who have no serious osteoporosis and no obvious surgical contraindications,the biological Total Hip Replacement is safe and feasible through careful and correct management during the perioperative period,which can effectively reduce the pain,restore the function of the hip joint and improve the quality of life of the patients.

关 键 词：股骨颈骨折 尿毒症 全髋关节置换术 围手术期 透析 

分 类 号：R274.12[医药卫生—中医骨伤科学]