全髋关节置换术后异位骨化及其预防

HETEROTOPIC OSSIFICATION AND ITS PREVENTION FOLLOWING TOTAL HIP ARTHROPLASTY

探讨全髋关节置换术后异位骨化发生的原因、机制及其预防方法。方法 :将 139例接受全髋关节置换的患者入院时随机分为 3组 ,A组 5 3例 ,B组 49例 ,C组 37例 ,分别于术后次日口服维生素C(10 0mg ,3/d)、消炎痛 (2 5mg ,3/d)和布洛芬 (2 0 0mg ,3/d) ,连续应用 4周。术后 3个月复查时行X线片检查。结果 :异位骨化情况按Brooker分类 ,A组 :0级 2 4例 ,Ⅰ级 6例 ,Ⅱ级 13例 ,Ⅲ级 7例 ,Ⅳ级 3例 ,异位骨化发生率5 4.7% (2 9/5 3)。B组 :0级 42例 ,Ⅰ级 5例 ,Ⅱ级 2例 ,发生率 14.3% (7/4 9)。C组 :0级 32例 ,Ⅰ级 3例 ,Ⅱ级、Ⅲ级各 1例 ,发生率 13.5 % (5 /37)。经统计学分析 ,异位骨化发生率A组与B组、A组与C组之间有显著差别 (P <0 .0 1) ,B组与C组之间无显著差别 (P >0 .0 5 )。结论 :全髋关节置换术后发生异位骨化的原因很多 ,发生机制尚不清楚 ,非甾体类消炎镇痛类药物可有效地预防其发生。

Objective:In order to investigate the causes and the preventive methods of the heterotopic ossification following total hip arthroplasty.Methods:One hundred and thirty-nine patients who had received total hip arthroplasty were divided into three groups randomly.There were fifty-three patients in group A,forty-nine patients in gruop B and thirty-seven patients in group C.Since the first day after the operation,the patients in group A had token vitamin C(100mg,three times each dy),in group B had token indometacin(25mg,three times each day)and in group C had token ibuprofen(200mg,three times each day) for four weeks.All the patients of three groups were exmined with X-ray three months later.Results:There were twenty-nine patients (54.7%,29/53) in group A,seven patients(14.3%,7/49)in group B and five patients (13.5%,5/37) in group C had the heterotopic ossification.There was notable difference between group A and group B/group C(P<0.01),and there was no difference between group B and group C(P>0.05).Conclusions:There are many causes related to the heterotopic ossification following total hip arthrolasty,and the mechanism of occurrence is not clear yet.Howeever the heterotopic ossification following total hip arthroplasty could be prevented by some medicines,such as indometacin and ibuprofen.