【摘要】：目的:探討虎潛丸加味結(jié)合打壓植骨在髖臼側(cè)骨缺損人工全髖關(guān)節(jié)置換術(shù)(THA)中的應(yīng)用及療效分析。方法:回顧分析本研究對(duì)臨沂市中醫(yī)院關(guān)節(jié)骨科自2012年09月至2014年10月期間收治入院的并有完整資料的50例(60髖)伴髖臼側(cè)骨缺損擬行人工全髖關(guān)節(jié)置換術(shù)的患者,采用隨機(jī)抽樣原則分為數(shù)量相等兩組,對(duì)照組實(shí)施打壓植骨重建髖臼的人工全髖關(guān)節(jié)置換術(shù),治療組在對(duì)照組的基礎(chǔ)上另服用虎潛丸加味6個(gè)月。隨訪內(nèi)容包括:①現(xiàn)場(chǎng)調(diào)查記錄患者的髖關(guān)節(jié)功能狀態(tài),行髖關(guān)節(jié)Harris評(píng)分;②觀察THA術(shù)后髖臼假體周圍骨密度,THA術(shù)后1周、3、6個(gè)月,用雙能X線骨密度儀記錄髖臼假體周圍骨密度(BMD)的變化,并將治療組與對(duì)照組BMD值做統(tǒng)計(jì)比較。結(jié)果:全部病歷獲得隨訪,經(jīng)治療6個(gè)月后。①髖關(guān)節(jié)功能采用Harris評(píng)分,治療組優(yōu)(㧐90分)12例15髖,良(80~89分)13例14髖,尚可(70~79分)1例1髖,無失敗病例(㩳70分),優(yōu)良率96.67%;對(duì)照組優(yōu)10例12髖,良8例10髖,尚可6例8髖,優(yōu)良率73.34%。②與對(duì)照組比較,THA術(shù)后3、6個(gè)月髖臼假體各興趣區(qū)骨密度下降趨勢(shì)較緩和,且術(shù)后3、6個(gè)月虎潛丸加味治療組髖臼假體周圍骨密度(Ⅲ區(qū))的差異有統(tǒng)計(jì)學(xué)意義(P0.05),其余各興趣區(qū)兩組相比差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:虎潛丸加味結(jié)合打壓植骨在伴髖臼側(cè)骨缺損人工全髖關(guān)節(jié)置換術(shù)中的應(yīng)用,相較于單獨(dú)運(yùn)用打壓植骨治療,通過術(shù)后髖關(guān)節(jié)Harris評(píng)分,髖臼假體周圍骨密度的對(duì)比,前者的療效優(yōu)于后者,說明伴髖臼側(cè)骨缺損髖關(guān)節(jié)疾病的治療應(yīng)將手術(shù)與促使移植骨和宿主骨快速整合及防止骨量減少的治療相結(jié)合。THA并不是治療的終結(jié),而是治療的開始。
[Abstract]:Objective: to investigate the application and curative effect of modified Huqian pill combined with compression bone graft in (THA) for total hip replacement with acetabular lateral bone defect. Methods: a retrospective analysis of 50 patients (60 hips) with acetabular lateral bone defect who were admitted to the Department of Orthopedics, Linyi traditional Chinese Medicine Hospital from September 2012 to October 2014, was performed. The principle of random sampling was used to divide the two groups into two groups. The control group was treated with artificial total hip arthroplasty, and the treatment group was treated with Huqian pill for 6 months on the basis of the control group. The follow-up included a field survey of the hip function of the patient and a Harris score of the hip joint. The bone mineral density around the acetabular prosthesis and the bone mineral density around the acetabular prosthesis after THA were observed 1 week and 6 months after tha. The changes of bone mineral density (BMD) around the acetabular prosthesis were recorded by dual energy X-ray absorptiometry, and the BMD values of the treatment group and the control group were compared statistically. Results: all the cases were followed up. After 6 months of treatment, Harris score was used to evaluate the hip function. In the treatment group, the excellent (? 90) scores were 12 cases (15 hips), good (80,89 points) 13 cases (14 hips), fair (7079 points) 1 case (1 hip). The excellent and good rate was 96.677.The excellent and good rate of the control group was excellent in 10 cases (12 hips), good in 8 hips (10 hips) and fair in 6 cases (8 hips). The excellent and good rate of 73.34.2 was lower than that of the control group in 3 and 6 months after tha. There was significant difference in bone mineral density (area 鈪，

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