中国组织工程研究

中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (15): 2390-2395.doi: 10.3969/j.issn.2095-4344.0758

• 骨与关节综述 bone and joint review • 上一篇    下一篇

髋关节结核病程与全髋关节置换的关系

马永海1，2，甄 平1，邵陇龙3，王 伟1   

  1. 1解放军兰州军区兰州总医院骨科，甘肃省兰州市 730000；2宁夏医科大学，宁夏回族自治区银川市 750000；3甘肃中医药大学，甘肃省兰州市 730000
  • 出版日期:2018-05-28 发布日期:2018-05-28
  • 通讯作者: 甄平，博士，主任医师，教授，硕士生导师，解放军兰州军区兰州总医院骨科，甘肃省兰州市 730000
  • 作者简介:马永海，男，1988年生，甘肃省广河县人，回族，宁夏医科大学在读硕士，主要从事骨关节结核方面的研究。
  • 基金资助:

    国家自然科学基金资助项目(81371983)

Relationship between hip tuberculosis course and total hip arthroplasty

Ma Yong-hai1, 2, Zhen Ping1, Shao Long-long3, Wang Wei1   

  1. 1Department of Orthopedics, Lanzhou General Hospital of Lanzhou Military Command, Lanzhou 730000, Gansu Province, China; 2Ningxia Medical University, Yinchuan 750000, Gansu Province, China; 3Gansu University of Chinese Medicine, Lanzhou 730000, Gansu Province, China
  • Online:2018-05-28 Published:2018-05-28
  • Contact: Zhen Ping, M.D., Chief physician, Professor, Master’s supervisor, Department of Orthopedics, Lanzhou General Hospital of Lanzhou Military Command, Lanzhou 730000, Gansu Province, China
  • About author:Ma Yong-hai, Master candidate, Department of Orthopedics, Lanzhou General Hospital of Lanzhou Military Command, Lanzhou 730000, Gansu Province, China; Ningxia Medical University, Yinchuan 750000, Gansu Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81371983

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摘要：

文章快速阅读：

 
 

 

文题释义：
髋关节结核：在活动期，患者可能表现为髋关节疼痛及跛行，患者会有夜间疼。根据受累程度可出现畸形、肢体缩短、肿胀、病理性脱位和窦道形成。由于髋关节结核的早期阶段诊断困难，X射线片常显示不出异常的征象，而当X射线上出现异常征象的时候，骨质的破坏程度一般都达到50%以上。髋关节结核治疗方式的选择，业已成为一个迫切需要解决的临床课题。
髋关节融合：髋关节融合虽然减轻了疼痛，并矫正畸形，增加关节的稳定性，但相应失去了关节的正常活动，对生活带来不便。应用克氏针固定对经济困难及全身情况差的患者是较好的选择，但应在大转子针尾处预弯，避免刺激局部组织或刺入腹腔。采用骨外固定行髋关节融合术可取得较好效果，但有钉道感染、生活不便的风险。内固定(克氏针、重建钢板)治疗给患者日常生活干扰较少。
 
摘要
背景：髋关节结核仅次于脊柱结核，每年有大量的患者被确诊髋关节结核。由于髋关节结核的早期阶段诊断困难，X射线片常显示不出异常的征象，而当X射线上出现异常征象的时候，骨质的破坏程度一般都达到50%以上。髋关节结核治疗方式的选择，业已成为一个迫切需要解决的临床课题。
目的：回顾近年来髋关节结核治疗的文献研究，为髋关节结核临床治疗实践提供参考。
方法：计算机检索PubMed和CNKI数据库中1969年1月至2017年3月髋关节结核治疗相关的文章，英文检索词“tubercular arthritis，hip，total hip replacement，treatment”；中文检索词“结核性关节炎，髋关节，全髋关节置换，治疗”。排除与文章研究目的无关及重复性的文章，纳入符合标准的42篇文献进行综述。
结果与结论：①目前髋关节结核治疗的重点是更多保留髋关节活动度与增加关节的稳定性；②应了解并讨论包括关节置换在内的各种治疗方式，具体治疗取决于病程的阶段；③随着人工关节置换技术的发展，全髋关节置换成为髋关节结核晚期患者的首选。越来越多的外科医生接受了在髋关节结核活跃期行全髋关节置换治疗。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
ORCID: 0000-0002-4937-3997(马永海)

关键词: 骨科植入物, 人工假体, 结核性关节炎, 髋关节, 全髋关节置换, 治疗, 国家自然科学基金

Abstract:

BACKGROUND: Hip tuberculosis was second to that of the spine. A great number of cases were diagnosed hip tuberculosis every year. The early stage of hip tuberculosis is difficult to be diagnosed, and the X-ray images often show no abnormal signs. When there is an abnormal sign on X-ray, the extent of bone destruction is generally more than 50%. Selection of treatment methods for the patients with hip tuberculosis is the important issue in face of every clinician.

OBJECTIVE: To review various types of research progress in clinical treatment of hip tuberculosis in recent years, and to provide reference for clinical treatment of hip tuberculosis.
METHODS: We retrieved database of PubMed and CNKI for studies concerning clinical treatment of hip tuberculosis published from January 1969 to March 2017. Key words were “tubercular arthritis, hip, total hip replacement, treatment”. After removal of repetitive or irrelevant articles, 42 articles were finally included.
RESULTS AND CONCLUSION: (1) In the treatment, current emphasis was on mobility with stability at the hip. (2) Adults with advanced arthritis should be informed and discussed the various treatment modalities including the joint replacement. (3) With the development of artificial arthroplasty, total hip replacement was the preferred choice for patients with advanced hip tuberculosis. More and more surgeons were taking up the challenge of putting the total hip arthroplasty in the active stage of the disease.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Tuberculosis, Hip Joint, Arthroplasty, Replacement, Hip

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