人工关节置换术治疗类风湿关节炎

Joint Replacement Arthroplasty in the Treatment of Rheumatoid Arthritis

类风湿关节炎(rheumatoid arthritis,RA)是一种病因未明的慢性全身性疾病,好发于手、腕、足等小关节,髋、膝、肩等大关节在疾病晚期亦可受累,以关节滑膜慢性炎症为主要表现,可引起关节肿痛,继而导致软骨破坏,引起关节畸形,最终出现不同程度的残疾。人工关节置换术是采用人工制造的关节来替代因疾病或外伤造成严重破坏,发生疼痛、变形、活动障碍及功能丧失的关节,已应用于临床数十年。本文总结回顾采用人工关节置换术治疗RA的手术适应症、禁忌症、手术方法、围手术期管理及并发症。

Rheumatoid arthritis （ RA） is a chronic autoimmune disorder that could affect small joint of hands and feet. Major joints such as h ip,knee and shoulder could also be affected at the late stage of the progres-sion. With chronic inflammation of the synovium,RA can cause joint pain and swelling,as well as destruction of cartilage,which leads to joint deformity and disability. Artificial joint replacement is a surgical intervention that uses prosthetic joints to replace the damaged joints with pain, deformity and loss of range of motion due to trauma or disease. It has been applied in clinical practice for decades. This article summarizes the indications, contrain- dications, surgical procedures, perioperative management and complications of prosthetic joint replacement for RA patients.【