双侧人工全髋关节置换治疗戈谢病并股骨头坏死一例报道并文献复习  

Bilateral total hip arthoplasty for Gaucher disease complicated with femoral hear necrosis:a case report and literature reivew

作　　者：邵泽萱 王冰 周珂 郑煜丽 孙海宁 SHAO Ze-xuan;WANG Bing;ZHOU Ke;ZHENG Yu-li;SUN Hai-ning(Graduate school,Jinzhou Medical University,Jinzhou,Liaoning,121001,China)

机构地区：[1]锦州医科大学研究生院,辽宁121001 [2]中国人民解放军联勤保障部队第九六〇医院骨病科,济南250031

出　　处：《中国骨与关节杂志》2023年第3期181-185,共5页Chinese Journal of Bone and Joint

摘　　要：目的 报告戈谢病(gaucher disease,GD)并双侧股骨头坏死1例,复习文献63例,探讨双侧人工全髋关节置换对于GD并双侧股骨头坏死的临床特点及其疗效。方法 回顾1例GD并双侧股骨头坏死患者,应用双髋关节置换治疗,检索中文外文数据库,对检索文献进行分析,包括流行病学特征、治疗方式、术后并发症及预后情况。结果 本例患者术中可见股骨头负重区以囊变和骨破坏为主,术后功能恢复良好。检索到11篇文献63例,术后并发症有:19例髋关节置换术后出现假体松动,12例术中大量出血,5例形成血肿,2例神经不可恢复损伤,2例术后感染,1例肺栓塞。结论 双侧人工全髋关节置换是治疗GD并股骨头坏死有效手段之一,且在术前应完善术前检查,包括血液系统、消化系统并积极备血,预防术中大量出血,术中注意髋臼厚度,尽量保留更多骨质,术后定期监测血常规,预防术后感染。Objective To report the clinical characteristics and treatment measures of a patient with Gaucher disease(GD) complicated with bilateral femoral head necrosis, and to explore the clinical efficacy of bilateral total hip arthroplasty for GD complicated with bilateral femoral head necrosis by literature review. Methods The application of bilateral hip arthroplasty in the treatment of GD with necrosis of the femoral head was analyzed. Chinese and foreign databases were searched with relevant search terms, and the retrieved literatures were analyzed, including epidemiological characteristics, treatment methods, postoperative complications and prognosis. Results In this case, intraoperative cystic lesions and bone destruction were found in the weight-bearing area of the femoral head, with good postoperative function recovery. Retrieval found 11 reports, including 63 cases. Postoperative complications: 19 cases of prosthetic loosening after hip replacement, 12 cases of massive intraoperative bleeding, 5 cases of hematoma, 2 cases of unrecoverable nerve injury, 2 cases of postoperative infection, and 1 case of pulmonary embolism. Conclusions Bilateral artificial total hip replacement is one of the effective means for GD and femoral head necrosis, and surgeons should conduct comprehensive examinations of blood system and digestive system to prevent massive hemorrhage and infection. Proper thickness of the acetabulum should also be preserved.

关 键 词：戈谢病 骨质破坏 髋 关节置换 脾功能亢进 

分 类 号：R687.4[医药卫生—骨科学]