本文選題：關(guān)節(jié)成形術(shù)　切入點：置換　出處：《中國組織工程研究》2017年11期

【摘要】：背景:強直性脊柱炎患者初次人工全髖關(guān)節(jié)置換后發(fā)生異位骨化較常見,會對術(shù)后功能造成一定影響。目的:探討強直性脊柱炎患者行初次全髖關(guān)節(jié)置換后發(fā)生異位骨化的危險因素。方法:納入2011年6月至2015年12月因強直性脊柱炎行初次全髖關(guān)節(jié)置換且隨訪達(dá)6個月以上的87例(132髖)患者,對患者的手術(shù)前后臨床資料和影像學(xué)資料進(jìn)行收集整理,影像學(xué)資料包括患者術(shù)前及術(shù)后的髖關(guān)節(jié)正側(cè)位X射線片。觀察末次隨訪X射線片假體周圍異位骨化的范圍,并按Brooker分型分為Ⅰ-Ⅳ型。將與異位骨化相關(guān)的危險因素分為兩大類,不可變因素包括年齡、性別、病程及術(shù)前髖關(guān)節(jié)是否強直;可變因素包括術(shù)前C-反應(yīng)蛋白、術(shù)前紅細(xì)胞沉降率、術(shù)中出血量、手術(shù)時間、假體類型及麻醉方式,從中找出與異位骨化發(fā)生相關(guān)的危險因素。結(jié)果與結(jié)論:(1)有43髖在術(shù)后發(fā)生了異位骨化,發(fā)生率為32.6%;(2)男性(P=0.029)、術(shù)前髖關(guān)節(jié)強直(P0.001)、病程(P=0.029)是異位骨化發(fā)生的不可變因素,增加了異位骨化的發(fā)生率;手術(shù)時間過長(P=0.031)和術(shù)中使用全麻(P=0.003)是異位骨化發(fā)生的可變因素,也會增加其發(fā)生率;患者的年齡、術(shù)前紅細(xì)胞沉降率及C-反應(yīng)蛋白、術(shù)中出血量和假體類型與術(shù)后異位骨化的發(fā)生無明顯相關(guān)性;(3)綜上,異位骨化的發(fā)生率與手術(shù)時間長短以及是否全麻等可變因素密切相關(guān),可以通過縮短手術(shù)時間以及術(shù)中盡量避免使用全麻來降低異位骨化的發(fā)生率。
[Abstract]:Background: heterotopic ossification is common in patients with ankylosing spondylitis after primary total hip replacement. Objective: to investigate the risk factors of heterotopic ossification in patients with ankylosing spondylitis after initial total hip replacement. Methods: from June 2011 to December 2015, the risk factors of heterotopic ossification were studied. The first total hip replacement and follow-up of more than 6 months in 87 patients with 132 hips), The clinical and imaging data of the patients before and after operation were collected and sorted. The imaging data included the anteroposterior and lateral radiographs of the hip joint before and after the operation. The range of heterotopic ossification around the prosthesis was observed during the last follow-up. According to Brooker classification, the risk factors associated with ectopic ossification were divided into two categories: immutable factors including age, sex, course of disease and ankylosis of hip joint before operation, and variable factors including preoperative C-reactive protein. The risk factors related to ectopic ossification were found out from the RBC sedimentation rate, intraoperative bleeding volume, operative time, prosthesis type and anaesthesia mode. Results and conclusion 43 hips had ectopic ossification after operation. The incidence of ectopic ossification was 32. 6% (P 0. 029), preoperative hip ankylosis (P 0. 001), course of disease (P 0. 029) were the immutable factors of ectopic ossification, the incidence of ectopic ossification was increased, the operative time was too long (P 0. 031) and the intraoperative use of general anesthesia (P0. 003) was the variable factor of ectopic ossification. Age, preoperative erythrocyte sedimentation rate and C-reactive protein, intraoperative blood loss and type of prosthesis were not significantly correlated with postoperative ectopic ossification. The incidence of ectopic ossification is closely related to the duration of operation and variable factors such as general anesthesia. The incidence of ectopic ossification can be reduced by shortening the operative time and avoiding the use of general anesthesia.
【作者單位】： 廣州中醫(yī)藥大學(xué)第一臨床醫(yī)學(xué)院;廣州中醫(yī)藥大學(xué)第三臨床醫(yī)學(xué)院;廣州中醫(yī)藥大學(xué)第一附屬醫(yī)院骨科中心;
【基金】：國家自然科學(xué)基金(KBC110134K11)“組蛋白去甲基化酶JMJD2蛋白家族在補腎法防治骨質(zhì)疏松癥中的作用機制” 廣東省自然科學(xué)基金(2015A030310203)“股骨頭壞死癥候異質(zhì)性與其分子分型及臨床MRI表現(xiàn)的相關(guān)性研究”~~
【分類號】：R593.23;R687.4

【相似文獻(xiàn)】

相關(guān)博士學(xué)位論文 前1條

1 郭凱;抑制DDR2策略在異位骨化和類風(fēng)濕性關(guān)節(jié)炎小鼠動物模型中的應(yīng)用[D];第四軍醫(yī)大學(xué);2016年

，

本文編號：1667569