Harris评分和X线在评价全髋关节置换术后疗效中的作用

Harris scores and X-ray manifestation in evaluating the outcome of patients with total hip replacement

目的探讨Harris评分和X线表现在评价全髋关节置换术（THA）后患者疗效中的相关性。方法从本组行THA手术的患者中随机抽取74例进行随访，进行Harris评分和X线片评估，比较两种方法在评价临床疗效中的差异。结果在33例Harris评分〉90分的患者中，27例X线评价良好，6例X线评价差。16例Harris评分80～90分的患者中，10例X线评价优良而6例差；13例Harris评分70～79分的患者中，X线评价优6例，差7例；12例Harris评分〈70分的患者中，其中X线评价4例优，8例差。在x线评价优与差的不同等级间，患者的功能评分间的差异有统计学意义（X^2=11．19，P〈0．05）。Pearson列联系数r=0．388，P〈0．05，显示两评价方式间具有一定的关联性。结论X线评价结果与Harris评分之间具有显著正相关关系，但相关密切度一般（r〈0．5）。单纯用Harris评分并不能够全面评估关节的真实状况，同时采用X线片和Harris评分来综合评估显得更为客观、全面。

Objective To discuss the correlation between Harris Scores and X-ray manifestation in evaluating the outcome of patients with total hip replacement. Methods 74 cases operated by total hip replacement in this group were selected randomly to be followed up. The clinical outcome was evaluated by Harris scores and X-ray manifestation. Results Among the 33 cases who had excellent Harris scores of more than 90 points, 27 cases had good x-ray findings while 6 had poor; 16 cases which had good Harris scores between 80 to 90 points, 10 had good x-ray findings and 6 had poor; 13 cases who had moderate Harris scores between 70 to 79, 6 had good x-ray while 7 had poor; 12 cases which had poor Harris scores of less than 70 points, 4 had good x-ray findings but 8 had poor. There was a significant correlation between the x-ray findings and the result of Harris Scores （X^2 = 11.19, P 〈 0. 05 ）. Pearson coefficient of contingency （ r = 0. 3 8 8 , P 〈 0. 0 5 ） , showing that there was some relevance between them. Conclusions There was statistical correlation between the x-ray findings and the results of Harris scores. But Harris Scores itself is not enough to evaluate the real conditions of the joint, we should use x-ray and Harris scores together to make evaluation more objective and comprehensive.