老年全髋关节置换术后假体脱位情况、影响因素及防范策略  

Prosthesis Dislocation,Risk Factors,and Prevention Strategies Following Total Hip Replacement in the Elderly

作　　者：赵磊 ZHAO Lei(Department of Orthopedics,Qixian Traditional Chinese Medicine Hospital,Kaifeng Henan 475200,China)

机构地区：[1]杞县中医院骨科,河南开封475200

出　　处：《临床研究》2025年第4期84-87,共4页Clinical Research

摘　　要：目的分析老年全髋关节置换术后假体脱位情况、影响因素及防范策略。方法纳入2012年1月至2022年12月期间于杞县中医院实施全髋关节置换术治疗的1523例(共收集1610例,脱落87例)老年患者,均随访6个月,以随访期间发生假体脱位的38例(共收集49例,脱落11例)老年患者为脱位组,以随访期间未发生假体脱位的1485例(共收集1561例,脱落76例)患者为对照组,进行回顾性研究。记录并比较两组患者年龄、性别、高血压、糖尿病、髋关节手术史、激素使用、手术入路、人工股骨头直径、术后股骨假体前倾角、假体放置位置、手术时间、手术出血量、住院时间、术后搬运、体位控制情况。以多因素Logistic回归分析影响老年全髋关节置换术后假体脱位的影响因素。结果1523例患者中术后随访6个月内发生假体脱位的患者共38例,发生率为2.50%。两组患者一般资料中年龄、糖尿病、髋关节手术史、手术入路、人工股骨头直径、术后股骨假体前倾角、假体放置位置、术后搬运、体位控制比较差异均有统计学意义(P<0.05);性别、高血压、激素使用、手术时间、手术出血量、住院时间比较差异无统计学意义(P>0.05)。经多因素Logistic回归分析,年龄≥75岁、有髋关节手术史、后外侧入路、人工股骨头直径<30 mm、术后股骨假体前倾角≥10°、非安全区放置假体、术后搬运不当、体位控制不严为影响老年全髋关节置换术后假体脱位的影响因素,差异均有统计学意义(P<0.05)。结论年龄≥75岁、有髋关节手术史、后外侧入路、人工股骨头直径<30 mm、术后股骨假体前倾角≥10°、非安全区放置假体、术后搬运不当、体位控制不严是影响老年全髋关节置换术患者发生术后假体脱位影响因素,临床需加强护理干预,根据影响因素,积极采取针对性措施,降低术后假体脱位发生率。Objective To analyze the incidence of prosthesis dislocation,risk factors,and prevention strategies following total hip replacement in elderly patients.Methods A total of 1,523 elderly patients who underwent total hip replacement at Qixian Traditional Chinese Medicine Hospital from January 2012 to December 2022 were included(1,610 patients collected,87 lost to follow-up).All patients were followed for 6 months.Among them,38 patients who experienced prosthesis dislocation during the follow-up period(49 collected,11 lost to follow-up)were assigned to the dislocation group,while 1,485 patients without dislocation during the follow-up(1,561 collected,76 lost to follow-up)formed the control group.A retrospective study was conducted.The age,sex,hypertension,diabetes,hip surgery history,hormone use,surgical approach,diameter of the artificial femoral head,postoperative femoral prosthesis anteversion angle,prosthesis placement position,surgical time,blood loss during surgery,length of hospital stay,transfer situation postoperatively,and position control were recorded and compared between the two groups.Multiple logistic regression analysis was employed to identify independent risk factors for prosthesis dislocation following total hip replacement in the elderly.Results Among the 1,523 patients,38 experienced prosthesis dislocation within 6 months post-surgery,resulting in a dislocation rate of 2.50%.There were statistically significant differences in age,diabetes,hip surgery history,surgical approach,diameter of the artificial femoral head,postoperative femoral prosthesis anteversion angle,prosthesis placement position,postoperative transfer,and position control between the two groups(P<0.05).However,no statistically significant differences were found in sex,hypertension,hormone use,surgical time,blood loss during surgery,or length of hospital stay(P>0.05).Through multiple logistic regression analysis,age,history of hip surgery,use of the posterolateral approach,diameter of the artificial femoral head<30 mm,postoperative

关 键 词：全髋关节置换术 术后假体脱位 影响因素 防范策略 

分 类 号：R323.4[医药卫生—人体解剖和组织胚胎学]