全髋关节置换术后病人健康相关生存质量评估

Evaluation of health-related quality of life in total hip arthroplasty patients

[目的]评价Harris评分在全髋关节置换术疗效评估中的局限性。[方法]对2005年9月～2006年1月47例（50髋）接受全髋关节置换术的病人进行6个月的前瞻性研究。在术前和术后6个月均对病人进行Harris评分和评估健康相关生存质量的SF-36简明健康状况调查量表（MOS36-item Short Form Health Survey，SF-36）评分，并分析Harris评分和SF-36各项评分之间的相关性。[结果]病人术后6个月的Harris评分和SF-36各项评分均较术前有统计学意义上的差异（P〈0．001），但SF-36各项评分的改善程度并不一致。Harris评分和SF-36生理功能（PF）和躯体疼痛（BP）项评分有相关性（r〉0．4，P〈0．001），但与SF-36其它方面评分无明显相关性（r〈0．4），或无相关性（P〉0．05）。[结论]虽然Harris评分能较好地评估全髋关节置换术对改善病人生理功能和缓解疼痛的疗效，但对于评价病人健康相关生存质量和其它方面的改善还存在局限性。因此，有必要将SF-36评分引入到全髋关节置换术的疗效评估中。

[ Objective ] To evaluate the limitations of Harris hip Score （HHS） in outcome assessments of total hip arthroplasty （THA）. [ Method] Based on a prospective study design,from Sep. 2005 to Jan. 2006,47 eligible patients （50 hips ） who had had total hip arthroplasty were interviewed and measured by the Harris hip Score （HHS） and Chinese - version Short - form 36 - item Health Survey （SF -36） before and six months after operations. The differences between the scores before and after operations were tested with t - test and the correlation between HHS and the SF - 36 domains were tested with Pearson correlation. [ Result] Both the HHS and eight domains of SF - 36 were significantly improved 6 months after operations compared with the scores before operations. However,except for the correlations between HHS and Physical Function （PF） and Bodily Pain （BP） domains of SF - 36 were significant （ r 〉 0.4,P 〈 0. 001 ） ,other domains of SF - 36 had poor （ r 〈 0. 4） or no correlations （ P 〉 0.05 ） with HHS. [ Conclusion] The result of this study suggest that HHS can not capture additional important quality of life domains except for physical function and pain relief that are influenced by THA. So it＇s necessary to combine HHS and a quality of life survey such as SF- 36 to allow a more global assessment of THA.