摘要
目的总结85岁以上患者初次髋关节置换的手术体会,分别比较全髋与半髋置换、生物型半髋与骨水泥型半髋假体的不同疗效。方法对48例患者行髋关节置换,其中全髋置换14例,半髋置换34例(生物型23例,骨水泥型11例)。统计手术时间、术中及术后出血量。术后随访行Harris评分及X线评估。结果全髋组手术时间、出血量均高于半髋组。术后3个月时半髋与全髋组及生物型半髋与骨水泥型半髋组间Harris评分差异均无统计学意义(P>0.05)。13例3个月后失访,共35例获最终随访,平均随访28(6～78)个月,最终随访时全髋组与半髋组Harris评分为(87.9±6.2)分与(82.4±5.8)分,两组间差异有统计学意义(P=0.042)。无假体松动、感染病例。结论 85岁以上患者同样可以考虑全髋关节置换,生物型与骨水泥型置换疗效相似但生物型假体更安全。
Objective To review the clinical results of primary hip arthroplasty in patients aged over 85 and compare the results of total hip arthroplasty（THA） and hemiarthroplasty and the results of cementless and cemented hemiarthroplasty.Methods Forty-eight patients were treated with hip arthroplasty including 14 THA and 34 hemiarthroplasty（11 cemented and 23 cementless）.The operation time and blood loss of intraoperative and postoperative period were compared.Harris scores and radiographs were also compared.Results There was significant difference in operation time and blood loss between THA group and hemiarthroplasty group.At 3 months＇ follow-up,there was no difference between THA group and hemiarthroplasty group in Harris scores,and also there was no difference between cementless hemiarthroplasty group and cemented hemiarthroplasty group.Thirteen patients were lost for follow-up 3 months after the operation.Thirtyfive patients were followed for an average time of 28.0 months（6 to 78 months） and the average Harris scores of THA group and hemiarthroplasty group were（87.9±6.2） and（82.4±5.8） separately（P=0.042）.There was no infection and aseptic loosening in all of the patients.Conclusion THA can also be a choice in patients aged over 85.The clinical results of the cementless hemiarthroplasty are like the results of cemented hemiarthroplasty but the cementless system is relatively safe.
出处
《中国骨与关节损伤杂志》
2010年第10期865-868,共4页
Chinese Journal of Bone and Joint Injury
