人工全髋关节置换术治疗56例强直性脊柱炎临床探究.doc

人工全髋关节置换术治疗56例强直性脊柱炎临床探究 　【关键词】 关节成形术 　　摘 要：［目的］探讨人工全髋关节置换术治疗强直性脊柱炎的疗效。［方法］对56例（98髋）强直性脊柱炎患者行人工全髋关节置换术，其中42例（76髋）进行了平均56（25～105）a的随访。［结果］至末次随访时，Harris评分由术前的平均268（4～51）分提高到了术后的平均852（55～94）分，优良率为895％。1例感染行Ⅱ期翻修；2例在扩髓时出现股骨颈或股骨距裂缝骨折，但未到达小粗隆以下，未予特殊处置；1例出现足下垂，术后3个月后恢复，1例深静脉血栓，余病例无假体松动、断裂以及脱位发生。异位骨化发生率92％（7髋），但对功能无明显影响。［结论］人工全髋关节置换术治疗强直性脊柱炎可以明显缓解髋关节疼痛，恢复关节功能，与其它病因的全髋关节置换术相比，并无较高的危险因素。 　　关键词：关节成形术； 强直性脊柱炎； 髋关节 Abstract：［Objective］To probe the efficacy of total hip arthroplasty（THA）in the treatment of patients with ankylosing spondilitis（AS）［Method］Ninetyeight THA were performed in 56 patients who had AS,and 42 patients（76 hips）were analyzed retrospectively with an average followup period of 56 years（ranged,25 to 55 years）The clinical results were evaluated by the Harris hip scoring system and radiographic analysis［Result］For the latest followup,the average Harris hip score improved from 268 points（ranged,4 to 51 points）preoperatively to 852 points（ranged,55 to 94 points）at the final postoperatively evaluation895% of the patients had an excellent or good results evaluated by Harris hip scoring system postoperativelyOne patient was revised for infection,fissured fracture of neck of femur or calcar femorale above the lesser trochanter happended in two patients,one patient had footdrop and recovered 3 months later,1 patient had deep vein thrombosisThere was no sign of loosening,dislocation or fracture of the prosthesisAccording to the system of Brooker,the incidence of heterotopic ossification was 92 %（7 hips）［Conclusion］THA can greatly relieve the pain of the patients who have AS and reconstruct the function of hip jointCompared with THA operated for other cause of disease,THA in AS leads to no high risk Key words：Arthroplasty； Ankylosing spondylitis； Hip 强直性脊柱炎（ankylosing spondylitis，AS）是致残率很高的慢性全身性炎性疾病，以骶髂关节、脊柱受累为特征，髋关节受累的发病率约为42％，而且双侧受累多见〔1〕，晚期出现髋关节畸形和功能障碍，严重影响日常生活。人工全髋关节置换术（toral hip arthroplasty，THA）是目前治疗AS的首选方法，但通常认为与其它病因的全髋关节置换术相比，存在较高的危险因素。本院自1995年3月～2003年5月采用THA治疗AS