人工髋关节置换术的并发症及应对措施.pdfVIP

中国药物警戒第9 卷第4 期 2012 年4 月 April, 2012, Vol.9, No.4 ： ： ： 图分类号 R95 ；R994.11 文献标识码 A 文章编号 1672-8629（2012 ）04-0215-03 人工髋关节置换术的并发症及应对措施 刘威 （国家食品药品监督管理局医疗器械技术审评中心，北京 100044 ） 通过检索pubMed、sciencedirect、CNKI 等数据库，查找关于人工髋关节术后并发症的中英文文献，总结了文献 摘要： 报道的人工髋关节置换术后引起的人工关节感染、关节脱位、假体松动、深静脉血栓形成等并发症的概况、影响因 素、防治方法及改进措施，以期为临床安全用械及提供参考。 髋关节置换术；并发症；预防 关键词： The Complications of Hip Replacement and Its Countermeasures LIU Wei (Center for Medical Device Evaluation, SFDA, Beijing 100044, China) Abstract: In order to decrease the complications of hip replacement. The databases included Pubmed, Sciencedirect and CNKI were searched, were reviewd. The risk factors and prevent measure of complications were reviewed. from related aticles published in Chinese or English. Infection as the frequent complication can be diminished by aseptic technique, prophylactic antibiotics and antibiotics -containing bone cement. Dislocation can be prevented by large-diameter femoral heads or posterior capsulotendinous repair. Aseptic loosening was related by mechanical factors and biological factors, interlocking revision -stem may be helpful. Deep vein thrombosis can be prevented by low molecular heparin, Continuous Enhanced Circulation Therapy show more promising. In summary, more device refine measure should developed to diminish the complication after hip replacement. Key words: hip replacement; complications; prevention 随着人口老龄化，因为骨质疏松引起股骨颈骨折是 术时间超过 3 小时，感染率高达 8.5%[2] 。此外感染与患 常见引起老年人残疾的原因，而人工髋关节置换术已经 ， 者的因素也有关系 Jenkins 报道肥胖与术后关节感染相 成为缓解疼痛、矫正畸形和恢复功能的有效方法。人工 关，体重指数超过 35.5 的患者感染率达 18.8% ，远超过 髋关节应用于临床多年，因合并症导致治疗失败的病例 总体感染率6.9%[3] 。此外Gillespie 注意到一般 措施如 也逐渐增多，给患者带来了额外的痛苦。本文通过检索 [4] 、糖