全髋关节置换术后脱位危险因素分析及防治措施

目的探讨人工髋关节置换术后脱位易发因素及其防治措施。方法回顾分析1998年1月～2002年12月来所进行的人工髋关节置换术共141例(151侧),年龄22～86岁,男66例,女75例,因股骨头坏死致手术64例,因股骨头/颈骨折者47例,其他30例,均采用后外侧切口。结果其中发生关节脱位7例(男3例,女4例),发生率2%。初次脱位时间于术后4天至半年不等。单次脱位5例,多次脱位2例,均为后脱位。保守治疗6例(10次),闭合手法复位成功;手术治疗2例(2次),1例术后1周发现脱位需手术切开复位并调整臼杯位置,1例手术松解软组织方可复位。结论手术避免假体安放不当及软组织失衡,术后正确护理可降低脱位的发生。

Risk Factors of hip dislocation and prophylactico-therapeutic measures after total hip replacement

Objective To investigate the risk factors which cause dislocation after hip replacement and its prophylactico-therapeutic measures. Method From January1998to December2000 ,141cases of total hip replacement were analyzed retrospectively. Result Among them ,hip dislocation was found in7cases after opera-tion ,the incidcnce was2%.All cases were posterior dislocation.The first-time dislocation happened from4days to6months after operation.Six cases were cured by closed reduction.Two cases were cured by operative treatment which one case underwent open reduction and regulated the position of acetabular cup.One underwent to release the soft tissues for reduction. Conclusion For preventing the postoperative dislocation of hip ,putting prosthesis into a corrcet position and paying attention to balance of the soft tissues are very important.Postoperative accurate nursing care can decrease the morbidity of dislocation