成人臀肌挛缩症的并发症及临床康复研究

目的 分析成人臀肌挛缩症(AGMC)并发症的形成机制，为管控并发症发展趋势提供依据。 方法 回顾性分析1 000例成人臀肌挛缩症C1型患者并发症的临床资料及其机制。 结果 ①本组患者中1 000例不同程度出现大转子滑囊炎、臀部肌筋膜炎、腰背部肌筋膜炎等并发症，臀肌挛缩症叶氏微创与临床康复治疗6~8周后前述炎症消失。②本组患者中762例不同程度出现膝关节磨损性关节炎，168例患者不同程度出现髋关节磨损性关节炎，12例患者不同程度出现踝关节磨损性关节炎；臀肌挛缩症叶氏微创与临床康复治疗后关节炎疼痛及活动受限症状未出现，原有关节摩擦音继续存在但强度没有再持续加重。③本组患者中586例出现不同程度骨盆倾斜、下肢不等长、脊柱侧弯；臀肌挛缩症叶氏微创与临床康复治疗6~10周后前述情况消失。④本组患者中3例出现双侧股骨头无菌性坏死，329例患者出现不同程度腰椎间盘突出。⑤本组患者中560例有心理抑郁倾向汉密顿抑郁量表评分为(12.9±4.1)分]，182例患者有心理抑郁汉密顿抑郁量表评分为(21.4±2.6)分]，6例患者有严重心理抑郁(汉密顿抑郁量表评分为大于24分)；臀肌挛缩症叶氏微创与临床康复治疗12~24周后心理抑郁消失。 结论 成人臀肌挛缩症的并发症可分为可逆性并发症和不可逆性并发症两大类。成人臀肌挛缩症的叶氏微创术与临床康复治疗可以治愈可逆性并发症；可以阻止或控制不可逆性并发症发展，但原有损害没有逆转修复。为减少和减轻臀肌挛缩症并发症的不可逆性伤害，成人臀肌挛缩症应尽早进行彻底手术与临床康复治疗。 

Complications and clinical rehabilitation of gluteal muscle contracture in adults

Objective To analyze the pathogenesis of the complications of gluteal muscle contracture (GMC) in adults and provide basis for the management of complications. Methods The clinical data and pathogenesis of the complications of type C1 GMC in 1 000 adult patients were analyzed retrospectively. Results ① 1 000 patients suffered from varying degrees of greater trochanteric bursitis, gluteal myofascitis and lumbar back myofascitis, and these complications disappeared after receiving the minimally invasive procedure method invented by Prof. Ye and 6-8 weeks of clinical rehabilitation. ② 762 patients suffered from varying degrees of wear-and-tear arthritis of the knee joint; 168 suffered from varying degrees of wear-and-tear arthritis of hip joint; 12 patients suffered from varying degrees of wear-and-tear arthritis of ankle joint. The arthritis pain and activity limitations disappeared after the minimally invasive procedure method and 6-8 weeks of clinical rehabilitation. The snapping sound of joints did not disappear, but had not developed. ③ 586 patients suffered from varying degrees of pelvic obliquity, leg length discrepancy and scoliosis. These conditions were cured after receiving the minimally invasive procedure and 6-10 weeks of clinical rehabilitation. ④ Three patients suffered from bilateral aseptic necrosis of femoral head; 329 patients suffered from varying degrees of lumbar disc herniation. ⑤ 560 patients were with depression tendency, Hamilton Depression Scale (HDC) score was 12.9±4.1; 182 patients suffered from depression, with HDC score of 21.4±2.6; 6 patients suffered from severe depression, with HDC score over 24. Their depression disappeared after receiving the minimally invasive procedure and 6-10 weeks of clinical rehabilitation. Conclusions The complications of AGMC can be classified as two categories: reversible complications and irreversible complications. The minimally invasive procedure method and clinical rehabilitation technique invented by Prof. Ye can cure reversible complications. It can stop or control the development of irreversible complications, but cannot correct the damage which already occurred. The early surgery and clinical rehabilitation are very important for treating AGMC in order to reduce and ease the irreversible complications.