老年骨质疏松症患者全髋置换围手术期处理

Treatment of osteoporotic total hip replacement before and after operation

目的 探讨老年骨质疏松症患者全髋置换围手术期注意事项。方法 回顾性分析76例行全髋置换的老年骨质疏松症患者的临床资料,入院及出院时均检测股骨颈部位骨密度值,术中谨慎操作,术后予以对症处理,随访髋关节的功能恢复及并发症情况。结果 76例患者入院、出院时T-score分别为-2.75±1.24和-0.88±0.96,自身前后对比差异有显著性(P<0.05)。平均随访时间为13.6月,根据Harris评分标准,优52例,良15例,优良率88％,与普通患者差异无显著性;出现并发症9例;伤口浅层感染1例;股骨干上段劈裂2例;下肢深静脉栓塞2例;中度髋关节疼痛4例。结论老年骨质疏松症患者病情复杂,围手术期应准确诊断,谨慎操作,术后给予严密对症处理。

Objective To study the key treatment points when total hip replacement(THR) was operated on old patients with osteoporosis. Methods 76 patients with osteoporosis were operated with THR, whose BMD were recorded before operation for diagnosis and after for prognosis. The function of hip joint and complications were followed up. Results There was significant difference between the T-score when inpatient (-2.75 ± 1.24) and that of outpatient (-0.88 ± 0.96) . 67 patients obtained excellent and good hip joint function and 9 complica-tions were noted after 13.6 month follow-up, which were similar to common THR. Conclusion Osteoporosis makes THR more complicated and difficult, so correct diagnosis, carefull operation and treatment of osteoporosis are essential.