强直性脊柱炎累及单侧髋关节行全髋关节置换的效果

Effect of total hip arthroplasty on postoperative ankylosing spondylitis involving unilateral hip joint

目的探讨强直性脊柱炎(AS)累及单侧髋关节的患者行全髋关节置换术(THA)后的关节功能及生活质量。方法选取2019年1月至2020年12月深圳平乐骨伤科医院(坪山区中医院)收治的48例AS累及单侧髋关节患者,采用THA治疗,评价治疗前、治疗后、随访3个月、随访6个月髋关节功能及生活质量变化,并以重复测量方差分析分析数据。结果48例AS患者的视觉模拟量表(VAS)评分,治疗后、随访3个月、随访6个月均持续降低,各时间点比较,差异有统计学意义(F=10.764,P<0.05);髋关节活动度、Harris评分,治疗后、随访3个月、随访6个月均持续升高,各时间点比较,差异有统计学意义(F=9.453、7.876,均为P<0.05);心理功能、社会功能、生活状态、躯体功能等简明健康调查问卷(SF-36)评分治疗后、随访3个月、6个月均持续提高,其中社会功能、生活状态、躯体功能评各个时间点比较,差异有统计学意义(F=8.657、9.880、12.647,均为P<0.05),心理功能评分各时间点比较,差异无统计学意义(F=2.843,P>0.05)。结论全髋关节置换术治疗强直性脊柱炎伴单侧髋关节病损能减轻患者疼痛症状,改善关节功能、提高生活质量。

Objective To investigate the effect of total hip arthroplasty(THA)on joint function and quality of life in patients with ankylosing spondylitis(AS).Methods A total of 48 patients with AS in Shenzhen Pingle Orthopedic Hospital(Pingshan District Hospital of Traditional Chinese Medicine)from January 2019 to December 2020 were treated with THA.The hip function and quality of life were compared before and after treatment,followed up for three and six months.The data were analyzed by repeated measurement analysis.Results The visual analogue scale(VAS)score of 48 patients with as decreased continuously after treatment,follow-up for three and six months,the difference was statistically significant at each time point(F=10.764,P<0.05).The range of motion of hip joint and Harris score increased continuously after the treatment.The follow-up time were three and six months,the difference was statistically significant at each time point(F=9.453,7.876,both P<0.05).The medical outcomes study(MOS)item short form health survey(SF-36)scores of psychological function,social function,living state and physical function continued to improve after treatment.The Olifferences of social function,living state and physical function scores were statistically significant at each follow-up time point(F=8.657,9.880,12.647,all P<0.05),but there was no significant difference in psychological function score at each time point(F=2.843,P>0.05).Conclusion Total hip arthroplasty in the treatment of ankylosing spondylitis can reduce the pain symptoms,promote the recovery of joint function and improve the quality of life.