CAJ | 학술논문

目的分析Ⅰ期双侧全髋关节置换术(THA)治疗系统性红斑狼疮(SLE)合并中晚期股骨头缺血性坏死(ANFH)围手术期护理的特点与要求.方法 1998年6月至2007年4月对17例SLE合并中晚期ANFH患者均行Ⅰ期双侧THA.围手术期护理包括心理支持、饮食控制、各种并发症观察及预见性护理措施、正确功能锻炼指导和健康宣教.比较手术前后Harris评分和SF.36评分.结果术后2例切口延迟愈合,1例假体脱位,1例大腿痛10个月,1例急性肾功能衰竭,经治疗后均好转.6例经彩超发现无症状下肢深静脉血栓,无肺栓塞、假体深部感染发生,无肾上腺皮质危象,术后Harris评分和SF-36评分均较术前有显著改善.本组病例术后平均随访28个月,髋关节疼痛及活动度明显改善,无假体松动.结论 Ⅰ期THA对SLE合并中晚期ANFH的早中期疗效良好,加强围手术期护理有助于提高手术成功率与降低并发症发生率.
목적 분석Ⅰ기쌍측전관관절치환술(THA)치료계통성홍반랑창(SLE)합병중만기고골두결혈성배사(ANFH)위수술기호리적특점여요구.방법 1998년6월지2007년4월대17례SLE합병중만기ANFH환자균행Ⅰ기쌍측THA.위수술기호리포괄심리지지、음식공제、각충병발증관찰급예견성호리조시、정학공능단련지도화건강선교.비교수술전후Harris평분화SF.36평분.결과 술후2례절구연지유합,1례가체탈위,1례대퇴통10개월,1례급성신공능쇠갈,경치료후균호전.6례경채초발현무증상하지심정맥혈전,무폐전새、가체심부감염발생,무신상선피질위상,술후Harris평분화SF-36평분균교술전유현저개선.본조병례술후평균수방28개월,관관절동통급활동도명현개선,무가체송동.결론 Ⅰ기THA대SLE합병중만기ANFH적조중기료효량호,가강위수술기호리유조우제고수술성공솔여강저병발증발생솔.
Objective To summarize the experience in the perioperative nursing of one-stage bilateral total hip arthroplaaty (THA) for the systemic lupus erythematosus (SLE) patients with avascular necrosis of the femoral head (ANFH).Methods From June 1998 to April 2007,17 cases of patients who were diagnosed as SLE with bilateral ANFH were treated by one-stage bilateral THA.Perioperative nursing included psychological support,diet control,observation and nursing of various complications,correct functional exercise and health education.Harris score and SF-36 score were evaluated before and after operation.Results There were 2 cases with delayed incision healing,1 with early prosthesis dislocation,1 with thigh pain for 10 months and 1 with acute renal failure postoperatively,which were improved and recovered after proper treatments.Asymptomatic deep vein thrombosis (DVT) in low extremities were detected by color Doppler ultrasonography in 6 cases.There were no pulmonary embolism and no deep infection around prosthesis.There was no Addisonian crisis postoperatively.The pain was relieved and the motion of joint was improved during follow-up.There was no radiological evidence of implant loosening.The Harris hip score and SF-36 score greatly alleviated after operation.All patients were followed up and the mean follow-up time was 28 months.Conclusions One-stage bilateral THA has good results for the patients with SLE and AVNH.Strengthening of perioperative nursing contributed to improvement of success rate of surgery and reduction of complication.