CAJ | 학술논문

目的探讨全髋关节置换术治疗强直性脊柱炎髋关节强直患者的疗效及并发症,并对其预后进行分析.方法将82例强直性脊柱炎髋关节强直患者按随机数字表法分为观察组和对照组,其中观察组42例,诊断后行早期全髋关节置换术治疗;对照组40例,诊断后行延迟全髋关节置换术治疗.观察两组患者术后的髋关节功能恢复情况,记录术后并发症发生情况,并随访其5年生存率情况.结果两组术后髋关节活动度、髋关节屈曲度、Harris评分均较术前明显提高,差异有统计学意义(P＜0.05),且观察组术后提高幅度更大,各项指标均高于对照组[髋关节活动度:175.25°±15.52°比122.95°±16.26°;髋关节屈曲度:85.65°±5.33°比70.78°±4.97°;Harris评分:(86.08±5.41)分比(73.92±6.62)分],差异有统计学意义(P＜0.05).观察组术后出现感染1例,脱位0例,假体松动2例,并发症发生率为7.14％(3/42);对照组术后出现感染5例,脱位2例,假体松动4例,并发症发生率为27.50％(11/40).观察组并发症发生率显著低于对照组,差异有统计学意义(x2=8.34,P＜ 0.01).观察组术后1,3年生存率稍高于对照组,但差异无统计学意义(P＞0.05);观察组术后5年生存率明显高于对照组[90.48％(38/42)比70.00％ (28/40)],差异有统计学意义(x2=7.57,P＜0.01).结论早期全髋关节置换术对强直性脊柱炎并发的髋关节强直具有显著的疗效,且早期手术疗效优于延迟手术.
목적 탐토전관관절치환술치료강직성척주염관관절강직환자적료효급병발증,병대기예후진행분석.방법 장82례강직성척주염관관절강직환자안수궤수자표법분위관찰조화대조조,기중관찰조42례,진단후행조기전관관절치환술치료;대조조40례,진단후행연지전관관절치환술치료.관찰량조환자술후적관관절공능회복정황,기록술후병발증발생정황,병수방기5년생존솔정황.결과 량조술후관관절활동도、관관절굴곡도、Harris평분균교술전명현제고,차이유통계학의의(P＜0.05),차관찰조술후제고폭도경대,각항지표균고우대조조[관관절활동도:175.25°±15.52°비122.95°±16.26°;관관절굴곡도:85.65°±5.33°비70.78°±4.97°;Harris평분:(86.08±5.41)분비(73.92±6.62)분],차이유통계학의의(P＜0.05).관찰조술후출현감염1례,탈위0례,가체송동2례,병발증발생솔위7.14％(3/42);대조조술후출현감염5례,탈위2례,가체송동4례,병발증발생솔위27.50％(11/40).관찰조병발증발생솔현저저우대조조,차이유통계학의의(x2=8.34,P＜ 0.01).관찰조술후1,3년생존솔초고우대조조,단차이무통계학의의(P＞0.05);관찰조술후5년생존솔명현고우대조조[90.48％(38/42)비70.00％ (28/40)],차이유통계학의의(x2=7.57,P＜0.01).결론 조기전관관절치환술대강직성척주염병발적관관절강직구유현저적료효,차조기수술료효우우연지수술.
Objective To explore the efficacy and complication of total hip arthroplasty in the treatment of ankylosing spondylitis hip joint ankylosis,and analyze its prognosis.Methods Eighty-two patients with ankylosing spondylitis hip joint ankylosis were divided into observation group and control group by random digits table method,the 42 patients in observation group were given total hip arthroplasty after the diagnosis of early,the 40 patients in control group were given delayed total hip arthroplasty.In the 2 groups,the recovery of hip joint function were observed,postoperative complication were recorded,and the 5-year survival rate situation were followed up.Results The activity of hip joint,degree of hip joint flexion and Harris score after operation in the 2 groups were significantly better than those before operation,there were statistical differences (P ＜ 0.05),the indexes after operation in observation group were significantly better than those in control group [activity of hip joint:175.25° ± 15.52° vs.122.95° ± 16.26° ; degree of hip joint flexion:85.65° ± 5.33° vs.70.78° ± 4.97° ;Harris score:(86.08 ± 5.41) scores vs.(73.92 ± 6.62)scores],there were statistical differences (P ＜ 0.05).Infection occurred in 1 case,dislocation in 0 case,prosthesis loosening in 2 cases in observation group,the rate of complication was 7.14％(3/42).Infection occurred in 5 cases,dislocation in 2 cases,prosthesis loosening in 4 cases in control group,the rate of complication was 27.50％ (11/40).The rate of complication in observation group was significantly lower than that in control group,there was statistical difference (x2 =8.34,P＜ 0.01).The 1,3-year survival rate in observation group was higher than that in control group,but there was no statistical differences (P ＞ 0.05).The 5-year survival rate in observation group was significantly higher than that in control group [90.48％(38/42) vs.70.00％ (28/40)],there was statistical difference (x2 =7.57,P ＜ 0.01).Conclusion Early total hip arthroplasty has significantly clinical effects in the treatment of patients with ankylosing spondylitis hip joint ankylosis,and its early operation curative effect is better than that of delayed operation.