老年髋关节假体周围骨质疏松发生情况及唑来磷酸的防治效果观察

Observation on the Occurrence of Osteoporosis around Hip Joint Prosthesis in the Elderly and the Preventive and Therapeutic Effect of Zoleiphosphate

目的:分析探讨老年髋关节假体周围骨质疏松发生情况及唑来磷酸的防治效果。方法:选取2017年9月至2018年9月期间在我院住院治疗的60例老年髋关节置换术后患者,按照患者年龄将其划分为甲、乙、丙三组,以评估不同年龄阶段患者的临床疗效是否存在差异,其中甲组患者10例,年龄处于60~69岁;乙组患者28例,年龄处于70~79岁;丙组患者22例,年龄处于80~89岁。所有骨质疏松老年患者均在实施手术后1周静脉用唑来磷酸一次,术后1年内静脉用1次,同时每天服用2次600mg的钙尔奇D。随访1年,比较患者术前和1年后的腰椎以及对侧髋关节的骨密度情况。结果:三组患者术后经过长达1年的服用唑来磷酸钠进行治疗后,其腰椎骨密度情况均显著优于本组术前(均P<0.05)。三组患者术后经过长达1年的服用唑来磷酸钠进行治疗后,其对侧股骨颈骨密度情况均显著优于本组术前(均P<0.05)。三组患者术后经过长达1年的服用唑来磷酸钠进行治疗后,其对侧全髋关节骨密度情况均显著优于本组术前(均P<0.05)。结论:对于老年髋关节置换术后患者使用唑来磷酸钠进行治疗能够有效预防其假体周围骨质疏松的出现,值得在临床上加以推广运用。

Objective: To analyze the incidence of osteoporosis around hip prosthesis in the elderly and the effect of zoledronic acid. Methods: From September 2017 to September 2018, 60 elderly patients with hip replacement who were hospitalized in our hospital were divided into three groups according to their ages, i.e. group A, group B and group C, to evaluate whether there is any difference in the clinical efficacy of patients at different ages, including 10 patients in group A, aged 60~69; 28 patients in group B, aged 70~79; 22 patients in group C, aged 60~69 The age is 80~89 years old. All the elderly patients with osteoporosis were treated with zoledronic acid once a week after the operation, once a year after the operation, and twice a day with 600 mg of calcic D. One year follow-up was conducted to compare the BMD of lumbar spine and contralateral hip joint before and after operation. Results: After taking zoledronic acid sodium for 1 year, the BMD of the three groups was significantly better than that of the group before operation(P<0.05). The bone mineral density of the contralateral femoral neck of the three groups was significantly higher than that of the group before operation(P<0.05). The bone mineral density of the contralateral total hip joint of the three groups was significantly higher than that of the group before operation(P<0.05). Conclusion: The use of sodium zolaiphosphate in elderly patients after hip arthroplasty can effectively prevent the occurrence of osteoporosis around the prosthesis, which is worth popularizing in clinic.