全髋关节置换术治疗类风湿性髋关节炎临床观察.docVIP

全髋关节置换术治疗类风湿性髋关节炎临床观察【摘要】 目的 探讨类风湿性髋关节炎患者行全髋关节置换术(THA)的临床效果，进而研究提高手术疗效、减少术后并发症的方法。方法 2005年9月至2010年12月对我院21例(38髋)类风湿性髋关节炎患者行全髋关节置换术，术后平均随访24个月，采用改良的髋关节Harris评分进行术后临床疗效评定，X线检查观察假体有无松动、下沉、脱位、异位骨化。结果 患者术后髋关节功能较术前均显著改善，疼痛明显缓解，髋关节屈曲畸形消失，髋关节活动范围达到前屈70°~105°，平均84.4°，后伸5°~15°，平均8.6°，髋关节Harris评分术前平均为(20.65±5.6)分，术后为(86.56±7.4)分，其中优24髋，良12髋，中1髋，差1髋，优良率为82.1％；术后无脱位、感染等并发症的发生。结论 类风湿性髋关节炎患者行全髋关节置换术可取得满意的临床效果 【关键词】 髋假体；髋关节;关节置换 The curative effect of total hip arthroplasty for the treatment of paitents with rheumatoid arthritis WANG Yong,gui,TANG Ben,shen.Department of Joint Families,Affiliated Hospital of Guiyang Medical College,Guiyang 550004,China 【Abstract】 Objective To observe the curative effect of total hip arthroplasty(THA)for the treatment of patients with rheumatoid arthritis(RA),and then research the methods of improving the Operative efficacy and reducing the postoperative complications.Methods Twenty,one patients(38 hips)with RA were performed with THA from September 2005 to December 2010 in our hospital.All cases were followed up for 24 months after operation.Results The function of hip joints was improved greatly.Pain was relieved significantly.No complication such as dislocation or infection happened.The average Harris hip score increased from (20.65±5.6) points before operation to (86.56±7.4) points after operation.According to Harris hip score,24 hips got excellent results，12 hips got good results，1 hips got fair results and 1 hips got poor results.The good and excellent rate was 82.1％.No dislocation and infection etc complications after postoperative happend.Conclusion The satisfactory curative effect of THA can be acquired for the treatment of patients with rheumatoid arthritis(RA). 【Key words】 Hip prosthesis；Hip joint；Arthroplasty 类风湿性关节炎(rheumatoid arthritis，RA)是一种以关节滑膜慢性、进行性、对称性炎症损害为特征，进行性及侵蚀性的关节炎为主要临床表现的慢性致残性自身免疫性疾病，病变经常累及髋关节，最终导致髋关节屈曲挛缩畸形，关节功能丧失［1］。全髋关节置换术(total hip arthroplasty，THA)作为目前公认的疗效肯定的改善关节功能的方法，已成为目前临床上治疗类风湿性髋关节炎重要的治疗手段。自2005年9月至