【摘要】：目的：探討一期病灶清除全髖關(guān)節(jié)置換術(shù)治療活動(dòng)期髖關(guān)節(jié)結(jié)核治療效果。方法：回顧性分析我院自2009年12月至2012年7月共收治活動(dòng)期髖關(guān)節(jié)結(jié)核9例，其中男7例、女2例，平均年齡40歲（16－63歲），合并肺結(jié)核3例，術(shù)前給予正規(guī)抗癆治療平均14天（7－20天），給予一期病灶清除全髖關(guān)節(jié)置換術(shù)、8例使用生物型假體、1例使用骨水泥型假體，術(shù)后繼續(xù)正規(guī)抗癆治療平均11個(gè)月（8－12個(gè)月），髖關(guān)節(jié)功能評(píng)價(jià)采用Harris髖關(guān)節(jié)評(píng)分系統(tǒng)（HHS）進(jìn)行評(píng)價(jià)，髖關(guān)節(jié)假體情況采用X線檢查評(píng)價(jià)，并定期復(fù)查血沉、C－反應(yīng)蛋白等相關(guān)檢查調(diào)整抗癆治療方案。結(jié)果：所有患者切口均一期愈合，術(shù)后無假體松動(dòng)、下沉、脫位、感染等并發(fā)癥、無血管、神經(jīng)并發(fā)癥，術(shù)前患者平均HHS評(píng)分33分（24－48分）、末次隨訪平均HHS評(píng)分92分（88－96分），平均隨訪時(shí)間20個(gè)月（8-36個(gè)月），所有患者均可不扶拐行走，X線檢查未見假體松動(dòng)、脫位等現(xiàn)象，無一例髖關(guān)節(jié)結(jié)核復(fù)發(fā)。結(jié)論：全髖關(guān)節(jié)置換術(shù)可以徹底清除病灶，，重建髖關(guān)節(jié)功能，解除患者病痛，提高患者生活質(zhì)量。對(duì)于活動(dòng)期髖關(guān)節(jié)結(jié)核病人通過全面的術(shù)前評(píng)估，改善患者營(yíng)養(yǎng)狀況，早期、聯(lián)用、適量、規(guī)則、全程抗癆治療，術(shù)中徹底病灶清除行全髖關(guān)節(jié)置換術(shù)是較為安全、有效的治療手段。
[Abstract]:Objective: to investigate the effect of one-stage debridement total hip arthroplasty on active hip tuberculosis. Methods: from December 2009 to July 2012, 9 patients with active hip tuberculosis, including 7 males and 2 females, with an average age of 40 years (16-63 years) and 3 cases with pulmonary tuberculosis, were retrospectively analyzed. The average of 14 days (7-20 days) was treated with regular antituberculous therapy before operation. 8 cases of total hip arthroplasty were treated with one-stage debridement and 1 case with bone cement prosthesis. The average of postoperative regular antituberculosis treatment was 11 months (8-12 months). The hip function was evaluated by Harris hip scoring system (HHS), and the hip prosthesis was evaluated by X-ray examination. And regular check ESR C-reactive protein and other related examinations to adjust anti-tuberculosis treatment. Results: all the incisions healed in the first stage. There were no complications such as prosthesis loosening, sinking, dislocation, infection, and no complications of blood vessels and nerves. The mean preoperative HHS score was 33 (24-48), the last follow-up was 92 (88-96), the average follow-up time was 20 months (8-36 months). There was no recurrence of hip tuberculosis. Conclusion: total hip replacement can completely clear the focus, reconstruct the function of the hip, relieve the pain and improve the quality of life of the patients. It is safe for patients with active hip tuberculosis to improve their nutritional status by comprehensive preoperative evaluation, early, combined, moderate, regular, total anti-tuberculosis treatment and complete debridement during operation. An effective treatment.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類號(hào)】：R529.2;R687.4

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