全髋置换术中骨水泥反应的原因及预防

Causes and prevention on cement reaction during total hip replacement

目的对人工全髋关节置换的病例进行分析总结,探讨人工全髋置换术中骨水泥反应发生的原因及预防.方法回顾调查1995年1月～2003年6月湘雅医院进行人工全髋关节置换术232例(239髋).男113例,女119例;平均年龄57.3岁.对术中出现骨水泥反应的患者术前、术后和随访期间的年龄、身体状况、症状、体征等进行总结评价,对术前准备、术中术后处理及预防进行探讨.结果232例(239髋)患者中5例现已死亡,失访5例,其余232例(242髋)患者随访0.5～9.0年,平均4.6年.骨水泥反应13例,发生率为5.60%,13例患者均为高龄患者,有明显的骨质疏松.使用现代骨水泥技术以后,只有2例患者出现明显的骨水泥反应.结论高龄、骨质疏松是骨水泥反应的高危因素;使用现代骨水泥技术可以降低骨水泥反应的发生率.

Objective: To analyse and evaluate the treatment of total hip replacement (THR), to discuss the causes and prevention and treatment of cement reaction after total hip replacent. Methods: 232 patients (239 hips) underwent THR from January 1995 to June 2003 in Xiangya Hospital. The series of patients included 113 male and 119 female, with an average age of 57.3 years. The symptom and sign before operation, preoperational preparation and transaction preopration was evaluated. Results: Of the 232 cases (242 hips), 5 cases were dead, 5 cases lost follow-up, the others were followed up for mean 4.6 years (from 0.5 years to 9.0 years). The cement reaction is in 13 cases, the rate of dislocation is 5.60%. Serious cement reaction happened in 2 of them. Conclusion: Advanced age and osteoporosis are the high risk factors to cement reaction; using the modern techniqh of cement can decrease the rate of cement reaction.