中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (39): 7398-7401.doi: 10.3969/j.issn.1673-8225.2010.39.044

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    下一篇

全髋关节置换治疗系统性红斑狼疮合并股骨头缺血性坏死6例

张紫机1，余世明2，康  焱1，雷紫雄2，何爱珊1，傅  明1，杨忠汉1，廖威明1,2，盛璞义1,2   

  1. 1中山大学附属第一医院关节外科，广东省广州市 510080；2中山大学附属第一医院黄埔关节外科中心，广东省广州市 510700
  • 出版日期:2010-09-24 发布日期:2010-09-24
  • 通讯作者: 盛璞义，副教授，副主任医师，双临床博士（中山大学骨科学博士学位及芬兰坦培雷大学医学院外科学博士学位），中山大学附属第一医院骨科研究所副所长，关节外科副主任(兼黄埔关节外科中心主任)，广东省广州市 510700 shengpuyi@hotmail.com
  • 作者简介:张紫机☆，男，1984年生，广东省河源市人，汉族，中山大学附属第一医院关节外科在读博士，主要从事关节置换术后感染和软骨组织工程研究。zhangziji1984@sina.com
  • 基金资助:

    广东省科委国际合作项目(2006B50107004)；广东省科委科技计划(2007B010600048)项目。

Total hip arthroplasty for avascular necrosis of the femoral head in 6 patients with systemic lupus erythematosus

Zhang Zi-ji1, Yu Shi-ming2, Kang Yan1, Lei Zi-xiong2, He Ai-shan1, Fu Ming1, Yang Zhong-han1, Liao Wei-ming 1,2, Sheng Pu-yi 1,2   

  1. 1 Department of Orthopedics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou  510080, Guangdong Province, China; 2 Huangpu Joint Surgery Center, First Affiliated Hospital of Sun Yat-sen University, Guangzhou  510700, Guangdong Province, China
  • Online:2010-09-24 Published:2010-09-24
  • Contact: Sheng Pu-yi, Associate professor, Associate chief physician, Department of Orthopedics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China shengpuyi@hotmail.com
  • About author:Zhang Zi-ji☆, Studying for doctorate, Department of Orthopedics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China zhangziji1984@sina.com
  • Supported by:

    the International Cooperation Program of Guangdong Provincial Science and Technology Commission, No. 2006B50107004*; Guangdong Provincial Science and Technology Commission Program, No. 2007B010600048*

PDF

524

被引次数

10

摘要：

背景：全髋关节置换是目前治疗髋关节疾患终末期的主要方法，疗效确切，但是对于伴有股骨头缺血性坏死的系统性红斑狼疮患者，常合并如严重骨质疏松症等其他疾患，目前国内外对于此类患者接受髋关节置换的效果尚不清楚。
目的：探讨系统性红斑狼疮合并股骨头缺血性坏死行全髋关节置换的临床效果。
方法：回顾性分析本科1998-06/2008-06行全髋关节置换的系统性红斑狼疮合并股骨头缺血性骨坏死患者临床资料。共6例(共6髋)获得随访，其中男1例，女5例，年龄46(28~67)岁，5髋使用生物固定型假体，1髋使用骨水泥型假体。治疗效果评估选用WOMAC骨关节炎指数，SF-36和Harris评分标准。
结果与结论：平均手术时间为141 (85~210) min，平均出血量为522(180~1 500) mL；平均随访时间3.5(1~10)年，1例于术后1.5年死于颅内出血。术后早期出现1例泌尿系统感染，其他病例在随访期间无假体感染、松动、脱位及深静脉血栓等并发症出现。随访时Harris评分、WOMAC骨性关节炎指数、SF-36评分均较术前明显改善(P < 0.05)。结果提示全髋关节置换可明显提高系统性红斑狼疮合并股骨头缺血性坏死患者的生活质量，中期临床效果良好。

关键词: 系统性红斑狼疮, 股骨头缺血性坏死, 全髋关节置换, 医学植入物, 生活质量

Abstract:

BACKGROUND: Total hip arthroplasty (THA) is the major method for treating hip joint disease at terminal stage with a precise effect. However, avascular necrosis of the femoral head (AVNFH) patients with systemic lupus erythematosus (SLE) are often complicated with severe osteoporosis or other disease. The effect of THA for these patients remains unclear.
OBJECTIVE: To explore the clinical outcome of THA for AVNFH in patients with SLE.
METHODS: A retrospective study was conducted for SLE patients with AVNFH from June 1998 to June 2008. A total of 6 patients were followed up (6 hips), including 1 male and 5 females, aged 46 years old (range 28 to 67 years), 5 bio-typed and 1 bone-cemented type. The treatment effects were evaluated using Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Medical Outcome Survey Short Form 36 (SF-36) and Harris hip score.
RESULTS AND CONCLUSION: The mean operation time was 141 minutes (85 to 210 minutes), bleeding 522 mL (180 to 1 500 mL). An average follow-up of 3.5 years (range from 1 to 10 years) were assessed. One patient died of hypertension 1.5 years after surgery, and 1 case developed urinary system infection early following postoperation. No infection, loosening, dislocation or deep venous thrombosis was observed. The average Harris Hip score, WOMAC scores and SF-36 were significantly improved compared with preoperative scores (P < 0.05). THA significantly improves quality of life of patients with SLE and AVNFH with good mid-term results after THA.

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