30年1459例初次骨病型人工髋关节置换术的临床回顾性分析

A retrospective analysis of 1459 cases of primary hip replacements for osteopathic patients during past 30 years

目的对30年来所施行的初次骨病型人工髋关节置换术1459例进行回顾性分析,探讨该类手术病例的一般特点。方法筛选出1973年1月～2009年7月30日30年间初次骨病型人工髋关节置换术病例,分析患者及病种构成情况,手术后髋关节功能改善和疼痛缓解情况、并发症发生情况。结果病例共计1459例,男584例,女875例,双侧置换者104例,合计1563髋,其中人工股骨头置换术422例,共424髋;人工全髋关节置换术1037例,共1139髋。人工股骨头置换术的病例以高龄股骨颈骨折患者为主(365例,占86.49%)。人工全髋关节置换术的病例以股骨头坏死并骨性关节炎(322例,占31.01%)为主。术后髋关节功能改善和疼痛缓解显著(100.0%)、并发症少(3.3%),未见感染。结论人工髋关节置换手术为治疗严重髋部疾患的确切有效手术,并发症少。

Objective To study the characteristics of primary hip replacements for primary osteopathic patients during past 30 years. Methods From January 1973 to July 30, 2009, 1563 cases of primary hip replacement for 1459 osteopathic patients were included in this study, including 584 male, 875 female, 104 bilateral replacements. The constituent ratio of diseases, improvement of hip function and pain, and the complications were analyzed. Results 424 artificial femoral head replacements were performed in 422 patients, 1139 total hip replacements were performed in 1037 patients. In artificial femoral head replacement cases, the main preoperative diagnosis was femoral neck fracture in the elder （365 cases, 86.49% ）; in total hip replacement cases, the preoperative diagnosis was femoral head necrosis with osteoarthritis （322 cases, 31.01% ）. Postoperatively, hip function and pain improved significantly （100%）. Patients with complications were rare （3.3%） ; no patient was found surgical site infection. Conclusions Artificial hip replacement is a definite and effective method to treat severe hip diseases, with rare complication.