非骨水泥型全髋关节置换术后生活质量评估

Evaluation of life quality in patients treated with cementless total hip arthroplasty

目的评估非骨水泥型人工全髋关节置换术（THA）术后患者的生活质量。方法对我院1999年1月一2005年3月采用非骨水泥假体行THA患者43例（43髋）进行至少3年（或直至死亡）的随访。所有入选患者均在术前行Harris评分。随访时再对其进行Harris评分和评估健康相关生活质量的SF-36简明健康状况调查量表（the MOS36-item Short Form Health Survey，SF-36）评分。结果共43例（43髋）患者获得至少3年的随访，Harris评分从术前平均43分（21—50分），提高到最新随访时平均92．4分（80～100分）（P〈0．001）。但最新随访时的SF-36评分除了躯体疼痛（BP）、生理功能（PF）和精神健康（MH）外，其余各项得分均较普通城市居民的参考值低（P〈0．05）。结论非骨水泥型THA术后，虽然患者的生理功能和疼痛缓解等生理健康方面的情况能得到较好的恢复，但是患者术后的生活质量还不理想；Harris评分不能有效地反映出患者除生理功能和疼痛以外其他一些生活质量方面的情况。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，对患者术后的生活质量加以关注。

Objective To evaluate quality of life in patients treated with cementless total hip arthroplasty （THA）. Method The information of 43 patients treated with cementless total hip arthroplasty were collected and reviewed. All of the patients were clinically evaluated by the Harris hip scoring （HHS） system before surgery and at the follow up. The quality of life of the patients were evaluated with the MOS 36-item short form health survey （ SF-36 ）. 43 patients were followed up for 3 years at least. Result The mean of Harris hip score were increased from 43.0 before operation to 92.4 at the latest foUow-up. The latest SF-36 scores of the patients were significantly lower than that in the health people except the limb pain, the llmb function and the mental health. Conclusion Although patients treated with cementless total hip arthroplasty could get significant improvement in physical function and pain relief, their life quality were not improved.