人工全髋关节置换术后脱位的原因分析和防治对策Analysis and prevention of dislocation after total hip replacement
黄炎;孔荣;方诗元;禹德万;李守民;张彪;
摘要(Abstract)：
[目的]探讨人工全髋关节置换术后脱位的原因分析和防治对策。[方法]本科自2001年1月~2006年12月行全髋置换术311例,对术后脱位15例患者进行回顾性分析,评价术后脱位的危险因素及防治对策。[结果]所有病例中术后6个月发生脱位15例(脱位率4.82%),首次全髋置换术后脱位11例,脱位率4.00%,而全髋翻修术后脱位4例,翻修手术脱位率11.11%,两者有显著差异(P<0.01)。首次全髋置换手术患者中,骨折组、侧卧外展试验阳性组、后外侧入路组、髋臼假体置于安全区外组,患者术后脱位率分别为6.04%、10.29%、4.52%、9.93%,均明显高于对照组(P<0.05),而不同性别、年龄以及使用不同直径股骨头的患者中术后脱位率无明显差异(P>0.05)。15例脱位中14例经保守治疗后未再发生脱位。1例患者发生习惯性脱位,行全髋翻修后未再发生脱位。[结论]全髋关节置换术后脱位与是否翻修,术前疾病状态,组织的肌力平衡,手术入路,假体位置的安放等因素有关,与患者性别、年龄以及假体设计无关。大多数脱位患者通过保守治疗未再发生脱位。通过改进手术方式,正确安放假体位置,及在医师指导下康复训练等会降低人工全髋关节置换术后脱位率。
关键词(KeyWords)： 全髋关节置换术;人工假体;术后脱位;原因
基金项目(Foundation):
作者(Author): 黄炎;孔荣;方诗元;禹德万;李守民;张彪;
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参考文献(References)：
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