CAJ | 학술논문

目的探讨髋关节强直人工关节置换手术的临床疗效和技术要点.方法回顾性分析自2010年7月至2013年6月在北京市通州区中西医结合医院住院的19例髋关节强直患者经过人工关节置换手术后的临床资料.其中强直性脊柱炎髋关节融合15例,先天性髋臼发育不良伴骨性关节炎3例,股骨头缺血性坏死1例.患病时间5 ～40年.其中15例髋关节完全强直,各方向均没有活动度,强直体位在双髋内收、屈髋10°～45°位.对术前、术中、术后的处理进行总结,提出预防和解决方法.结果本组19例均获得随访,随访时间6个月至3.5年,平均(2.5 ±0.5)年.患者手术后切口均为Ⅰ期愈合.无神经、血管损伤,肺栓塞、急性心功能不全、急性肾功能不全、肺内感染、深静脉血栓等早期并发症.在随访期间无髋关节脱位,假体松动或下沉,无术后迟发性感染,髋关节活动度比术前明显增加.有3例发生异位骨化,占15.8％.结论人工关节置换是治疗髋关节强直的理想方法,能明显改善关节功能,提高生活质量.手术技术直接影响术后效果,髋臼的处理是术中难点.髋关节外侧入路操作简便,出血少,能有效预防人工关节置换术后髋关节脱位.
목적 탐토관관절강직인공관절치환수술적림상료효화기술요점.방법 회고성분석자2010년7월지2013년6월재북경시통주구중서의결합의원주원적19례관관절강직환자경과인공관절치환수술후적림상자료.기중강직성척주염관관절융합15례,선천성관구발육불량반골성관절염3례,고골두결혈성배사1례.환병시간5 ～40년.기중15례관관절완전강직,각방향균몰유활동도,강직체위재쌍관내수、굴관10°～45°위.대술전、술중、술후적처리진행총결,제출예방화해결방법.결과 본조19례균획득수방,수방시간6개월지3.5년,평균(2.5 ±0.5)년.환자수술후절구균위Ⅰ기유합.무신경、혈관손상,폐전새、급성심공능불전、급성신공능불전、폐내감염、심정맥혈전등조기병발증.재수방기간무관관절탈위,가체송동혹하침,무술후지발성감염,관관절활동도비술전명현증가.유3례발생이위골화,점15.8％.결론 인공관절치환시치료관관절강직적이상방법,능명현개선관절공능,제고생활질량.수술기술직접영향술후효과,관구적처리시술중난점.관관절외측입로조작간편,출혈소,능유효예방인공관절치환술후관관절탈위.
Objective To investigate the clinical curative effect and the technique of hip artificial joint replacement in the treatment of ankylosis of hip joint.Methods A retrospective data of 19 patients with hip joint ankylosis operated by artificial joint replacement was reviewed between July 2010 and June 2013 in our hospital.The hipfusion due to ankylosing spondylitis was in 15 cases; congenital acetabular dysplasia and osteoarthritis were in 3 cases; ischemic necrosis of femoral head was in 1 case.The history of all the cases was 5-40 years in which 15 cases of hip joint was complete rigidity and no activity with hip 10 °-45 ° of adduction and flexion.The preoperative,intraoperative and postoperative data were summarized.Results Totally 19 cases were all followed up and the follow-up time was 0.5-3.5 years.All the patients had no complications after operation,such as nerve,vascular injury,acute pulmonary embolism,acute renal and heart failure,pulmonary infection and deep vein thrombosis.During the follow-up period,all the patients had no dislocation,loosening prosthesis and delayed infection.The postoperative activity of hip joint was significantly improved after operation.There were 3 cases (15.8％) of heterotopic ossification.Conclusions Artificial joint replacement is an ideal method in the treatment of hip joint ankylosis,which can significantly improve the joint function and the quality of life.Intraoperative technology directly affects the effect after operation.The lateral approach of hip joint has a lot of advantages and can effectively prevent the dislocation after artificial joint replacement.