广州地区初次髋关节置换者病因构成:同一机构8年974例资料回顾

Etiological composition of patients undergoing total hip replacement for the first time in Guangzhou:A retrospective analysis of 974 cases in the same institute within 8 years

背景:人工髋关节置换的病因、性别及年龄均有一定的关系,常见原因有髋关节骨性关节炎、老年股骨颈骨折、股骨头无菌性坏死及系统性疾病一起髋关节局部病变。目的:分析行初次髋关节置换患者的病因构成及其在性别、年龄上的分布特点。方法:对2003-01/2010-12在南方医科大学附属南方医院行初次髋关节置换患者974例行回顾性分析,均为广州市居民,按照出院诊断分成9类,统计其年龄和性别构成。结果与结论:在974例初次髋关节置换患者中,原发性骨关节炎70例(7.19%),先天性髋关节发育异常64例(6.57%),强直性脊柱炎78例(8.01%),股骨头缺血性坏死518例(53.18%),股骨颈骨折220例(22.59%),髋部肿瘤10例(1.03%),类风湿性关节炎8例(0.82%),感染性关节炎4例(0.42%),血液系统疾病2例(0.21%)。50岁以上患者所占比例显著大于50岁以下(包括50岁)(χ2=104,P<0.05)。女性患者所占比例高于男性,但差异无显著性意义(χ2=1.73,P>0.05)。结果显示,于南方医科大学附属南方医院行初次髋关节置换的广州患者病因复杂,主要病因是股骨头缺血性坏死和股骨颈骨折,以50岁以上患者为主,男女比例相当。

BACKGROUND： There are relationships between the causes, gender and age of patients with total hip replacement. The common causes are hip osteoarthritis, aged femoral neck fracture, aseptic necrosis of femoral head and hip local lesion in systemic disease. OBJECTIVE： To study the etiological composition of patients with total hip replacement for the first time and its distribution in ages and genders. METHODS： A retrospective analysis was performed in 974 patients received total hip replacement for the first time in Affiliated Nanfang Hospital of Southern Medical University from January 2003 to December 2010. All the patients were Guangzhou residents. The patients were divided into 9 groups according to discharge diagnosis, and the composition of ages and genders was analyzed. RESULTS AND CONCLUSION： Seventy patients were of primary osteoarthritis （7.19%）, 64 of congenital hip dysplasia （6.57%）, 78 of ankylosing spondylitis （8.01%）, 518 of avascular necrosis of femoral head （53.18%）, 220 of femoral neck fracture （22.59%）, 10 of tumor of hip （1.03%）, 8 of rheumatoid arthritis （0.82%）, 4 of infective arthritis （0.42%）, and 2 patients were of hematological disease （0.21%）. The proportion of patients over 50 years old was obviously higher than that of the patients under age 50 and age 50 （χ2= 104, P 0.05）. The proportion of female patients was higher than that of the male patients, but the difference was not significant （χ2= 1.73, P 0.05）. The results showed that the causes of the patients received total hip replacement for the first time in Affiliated Nanfang Hospital of Southern Medical University in Guangzhou were complex, the major causes were avascular necrosis of femoral head and femoral neck fracture, the main patients were over 50 years old, and the proportions of female and male patients were similar.