人工全髋置换术后疼痛原因分析

Analysis of causes of pain after total hip arthroplasty

目的 探讨人工全髋置换术后疼痛的发生原因、发生情况及其处理。方法 对 89例行人工全髋置换术的患者 ( 89髋 )进行随访 ,平均随访时间 7年 ,摄骨盆X线片 ,并对随访结果作统计学处理。结果 89髋中 ,3 1髋存在不同程度疼痛 ,随术后时间延长 ,疼痛发生率逐渐升高 ,其中 6髋存在X线松动征象 ,11髋存在临床松动征象。 3例异位骨化患者术后轻中度疼痛 ,2髋晚期感染 ,术后严重疼痛。结论 假体移位、下沉是造成人工全髋置换术后疼痛的主要原因 ;X线松动征象与疼痛关系并不确定 ,疼痛取决于松动程度 ;感染及异位骨化是造成术后早期疼痛的重要原因。

Objective To investigate the causes,the onset status and the treatment of the pain after total hip arthroplasty (THA). Methods 89 cases undergone THA were followed up for an average of 7 years. They all took X ray of pelvis. And the data were analyzed statistically. Results Of 89 hips, 31 hips had pain to some extents, and the incidence of pain increased with the time extending. 6 hips with radiographic loosening and 11 hips with clinical loosening had pain after THA. 3 hips with heterotopic ossification had moderate pain and 2 hips with terminal infection had serious pain. Conclusion The main cause of pain after THA is the loosening or subsidence of the prosthesis. The relationship between the pain and the radiographic loosening is not certain. The pain lies on the degree of loosening. The infection and heterotopic ossification are important reasons of early pain after operation.