髋臼中心化在髋臼发育不良全髋关节置换术中的应用探讨与研究

时间:2022-03-13 09:37:31 公文范文 来源:网友投稿
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  【摘要】 目的 探讨髋臼中心化在髋臼发育不良全髋关节置换术中的应用效果。方法 40例行全髋关节置换术的髋臼发育不良患者, 采用随机数字法分为对照组和观察组, 每组20例。对照组采用Harris常规方法处理, 观察组采用髋臼中心化手术技术处理。比较两组患者手术前后Harris评分及髋臼旋转中心测量结果。结果 两组患者手术后6、12个月Harris 评分均显著高于手术前, 且观察组患者显著高于对照组, 差异具有统计学意义(P<0.05)。观察组患者手术后髋臼旋转中心测量结果与对照组比较差异具有统计学意义(t=5.684、5.606, P<0.05)。观察组患者手术后髋臼旋转中心比对照组更接近于真实的髋臼旋转中心。结论 髋臼中心化用于髋臼发育不良全髋关节置换术可有效纠正髋臼旋转中心, 改善患者的髋关節功能, 值得推广应用。
  【关键词】 髋臼中心化;髋臼发育不良;全髋关节置换术
  DOI:10.14163/j.cnki.11-5547/r.2018.12.008
  【Abstract】 Objective To discuss the application effect of acetabular centralization in total hip arthroplasty with acetabular dysplasia. Methods A total of 40 acetabular dysplasia patients with total hip arthroplasty were divided by random number table method into control group and observation group, with
  20 cases in each group. The control group received Harris routine method, and the observation group received acetabular centralization surgical technique. Comparison were made on Harris score before and after operation and measurement results of acetabular rotation center between the two groups. Results Both groups had obviously higher Harris score in postoperative 6 and 12 months than before operation, and the observation group was obviously higher than the control group. Their difference was statistically significant (P<0.05). The observation group had statistically significant difference in measurement results of acetabular rotation center after operation, comparing with the control group (t=5.684, 5.606, P<0.05). The acetabular rotation center of the patients in the observation group was closer to the true acetabular rotation center than the control group. Conclusion Application of acetabular centralization in total hip arthroplasty with acetabular dysplasia can effectively correct acetabular rotation center and improve the hip function in patients. It is worthy of popularization and application.
  【Key words】 Acetabular centralization; Acetabular dysplasia; Total hip arthroplasty
  目前, 髋臼中心发育不良髋关节骨性关节炎的最佳治疗方法为全髋关节置换术, 但是由于患者的髋关节旋转中心发生偏移, 因此恢复并重建其髋关节旋转中心是髋臼发育不良的人工髋关节置换的关键问题[1]。研究发现, 真臼是髋臼杯固定骨质最佳部位, 只有将髋臼中心化, 髋臼杯置入才牢固、稳定, 符合生物力线平衡, 但是该结论尚待验证[2]。本课题以2015年4月~2016年11月在本院进行全髋关节置换术的40例髋臼发育不良患者作为研究对象, 探讨髋臼中心化在髋臼发育不良全髋关节置换术中的应用效果, 报告
  如下。
  1 资料与方法
  1. 1 一般资料 选取2015年4月~2016年11月在本院进行全髋关节置换术的髋臼发育不良患者40例作为研究对象, 采用随机数字法分为对照组和观察组, 每组20例。对照组20例患者(24髋)中男4例, 女16例;年龄27~76岁, 平均年龄(51.33±8.29)岁;根据Hartofilakidis法分为Ⅰ型14髋, Ⅱ型8髋, Ⅲ型2髋。观察组20例患者(25髋)中男5例, 女15例;年龄28~79岁, 平均年龄(52.21±8.93)岁;根据Hartofilakidis法分为Ⅰ型15髋, Ⅱ型7髋, Ⅲ型3髋。两组患者一般资料比较差异无统计学意义(P>0.05), 具有可比性。所有患者均符合髋臼中心发育不良髋关节骨性关节炎临床诊断标准, 本课题在伦理委员会批准、监督下进行, 患者对治疗方法等知情同意。

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