人工髋关节置换术后翻修原因及疗效分析

目的分析人工髋关节置换术后翻修原因及疗效。方法回顾性分析2006年3月～2012年6月重庆三峡中心医院收治的36例人工髋关节置换术失败进行翻修患者的临床资料。观察髋关节功能Harris标准评分及恢复情况。结果本研究获随访36例，随访时间8～68个月，平均34个月。无感染复发病例、无人工髋关节脱位、假体松动及下沉等。术前髋关节功能评分为31-46分，平均（39．00±4．97）分，术后髋关节功能评分为73～96分，平均（91．00±5．43）分，术后明显优于术前，差异有统计学意义（P〈0．05）。髋关节功能恢复优23例，良11例，优良率为94.4％。结论髋关节置换术后翻修的主要原因与手术操作技术和患者自身因素有关。强调术前必须作详细评估，严格掌握手术指征，提高手术技能，正确选择假体，重视感染预防，增强术后护理质量及患者自我保护意识等，是提高人工髋关节翻修术治疗效果的重要措施。

Reason and curative effect analysis of revision of total hip arthroplasty

Objective To analyze the reason and curative effect of revision of total hip arthmplasty. Methods Clinical data of 36 cases performed the revision of total hip arthmplasty for total hip arthmplasty failure from March 2006 to June 2012 in Three Gorges Central Hospital of Chongqing were retrospectively analyzed. The Harris hip score and re- covery were observed. Results 36 of the cases were followed up for 8-68 months, and the average time were 34 months. No complications such as infection ,dislocation and loosening and submersion of the prothesis occurred. The postoperative Harris hip score before operation was 31-46 scores,and the mean score was （39.00±4.97） scores, the postoperative Harris hip score after operation was 73-96 scores, and the mean score was （91.00±5.43） scores, Harris hip score in postoperative was better than preoperative, the difference was statistically significant （P 〈 0.05）. There were 23 cases with excellent recovery, 11 cases with good recovery, the good rate was 94.4%. Conclusion The main reason for the revision of total hip arthmplasty is related to operation skills and the patient＇s own factors. The detail preoperative evaluation is necessary, master the operation indications strictly, improve the operation skills, select the prosthesis type correctly, attach great importance to the joint infection prevention, and also strengthen nursing care ＇after surgery as well as protective consciousness of patients＂ selves, which were important measures to improve the effect of revision of total hip arthmplasty.