成人非创伤性股骨头坏死入院资料的分析  

Analysis of in-patient data of adult non-traumatic necrosis of femoral head

作　　者：尹素然 岳聚安 郭晓忠 张启栋[4] 余华晨 刘沛 文鹏飞 YIN Su-ran;YUE Ju-an;GUO Xiao-zhong;ZHANG Qi-dong;YU Hua-chen;LIU Pei;WEN Peng-fei(Department of Orthopaedics,The Second Affiliated Hospital,Xingtai Medical College,Xingtai,Hebei 054000,China;Department of Joint Surgery,Aviation General Hospital,Beijing 100012,China;Orthopaedic Department,Jishuitan Hospital,Beijing 100029,China;Department of Joint Surgery,China-Japan Friendship Hospital,Beijing 100029,China;School of Clinical Medicine,China-Japan Friendship Hospital,Union Medical College,Beijing 100029,China)

机构地区：[1]邢台医学高等专科学校第二附属医院骨二科,河北邢台054000 [2]航空总医院关节外科,北京100012 [3]积水潭医院矫形骨科,北京100029 [4]中日友好医院关节外科,北京100029 [5]协和医学院附属中日友好医院临床医学院,北京100029

出　　处：《中国矫形外科杂志》2025年第6期548-551,556,共5页Orthopedic Journal of China

基　　金：国家自然科学基金面上项目(编号:8207091413)。

摘　　要：[目的]回顾性分析2018年1月—2023年1月诊断为非创伤性股骨头坏死(osteonecrosis of femoral head,ONFH)并接受手术治疗的住院患者的临床资料,分析其病因、临床诊断及误诊的现况,为本病的预防、诊断和治疗提供参考。[方法]收集患者的临床资料:性别、年龄、病因、分期及首次就诊医院级别、诊断等。将数据录入信息表格并进行统计和分析。[结果]180例ONFH患者纳入研究,激素性占比55.6%、酒精性占比30.6%、特发性占比13.9%。激素性ONFH平均发病时间(17.3±3.7)个月,平均使用剂量(9.3±3.7)g;酒精性ONFH饮酒时间平均(15.7±6.9)年,平均每日饮酒(374.7±163.6)m L;特发性ONFH无明显诱因。酒精组患者平均年龄显著大于激素组和特发组[(44.9±9.8)岁vs(39.2±13.6)岁vs(39.7±10.2)岁,P=0.005];酒精组男性比例最高,为98.2%,特发组女性比例较高,为32.0%,差异有统计学意义(P<0.05);酒精组病程显著长于激素组和特发组[(18.2±6.0)个月vs(15.3±2.7)个月vs(8.7±3.3)个月,P=0.013]。三甲医院首次就诊确诊率最高,为61.9%,一级医院最低,为22.2%,差异有统计学意义(P<0.05)。ONFH最容易被误诊为腰椎间盘突出症。[结论]非创伤性ONFH患者以中年男性为主,激素的使用仍然是ONFH发病的首要原因。ONFH的误诊率较高。[Objective]To retrospectively analyze the etiology,clinical diagnosis and current status of misdiagnosis of the inpatients who were undergoing surgical treatment for non-traumatic osteonecrosis of femoral head(ONFH)between January 2018 and January 2023 for providing a reference of the prevention,diagnosis and treatment of this disease.[Methods]Clinical data of patients were collected,involv-ing gender,age,etiology,stage,grade of hospital at first visiting,diagnosis,etc.The data were listed in the information table and statistic analysis was conducted.[Results]A total of 180 patients with ONFH were included in the study,55.6%were steroid,30.6%were alcoholic,and 13.9%were idiopathic.The average onset time of steroid ONFH was(17.3±3.7)months,with the average dose of(9.3±3.7)g;the average drinking of alcoholic ONFH lasted for(15.7±6.9)years,with the average drinking of(374.7±163.6)mL per day,while the idiopathic ONFH had no obvious cause.The mean age of patients in alcohol group was significantly higher than that in steroid group and idiopathic group[(44.9±9.8)years vs(39.2±13.6)years vs(39.7±10.2)years,P=0.005].The proportion of male in the alcohol group was the highest(98.2%),while the proportion of female in the idiopathicgroup was the highest(32.0%),with statistically significant differences(P<0.05).The course of disease in the alcohol group was significantly longer than that in the steroid group and the idiopathic group[(18.2±6.0)months vs(15.3±2.7)months vs(8.7±3.3)months,P=0.013].The diagnosis rate at the first visit was the highest(61.9%)in the top grade hospitals,and the low-est(22.2%)in the primary hospitals,with statistical significance(P<0.05).The ONFH was most commonly misdiagnosed as lumbar disc her-niation.[Conclusion]The majority of non-traumatic ONFH patients are middle-aged men,and hormone use is still the primary cause of ON-FH.The misdiagnosis rate of ONFH is higher.

关 键 词：非创伤性股骨头坏死 单中心研究 激素 腰椎间盘突出 

分 类 号：R681.8[医药卫生—骨科学]