透析患者骨水泥型髋关节置换术后的近期疗效观察

目的观察一组因肾功能不全行透析治疗的患者髋关节置换术后的近期疗效,总结该类患者髋关节置换治疗经验。方法随访肾功能不全行透析治疗的患者初次髋关节置换9例（11髋）,观察该组患者的近期疗效。结果术后平均随访4.4年（2～9年,随访至2007年12月）,11髋留存9髋,其假体存留率为81.8%;术前Harris评分平均47.8分,术后Harris评分平均85.8分,优良率77.8%（7/9髋）。术后3个月内死亡病例2例,死亡率22%。术后获得随访9髋,均未发生假体周围感染。结论对于因肾功能不全进行透析治疗的患者的髋关节疾病,骨水泥型髋关节置换是一种有效的治疗方法,术后患者疼痛缓解,髋关节功能改善,生活质量明显提高。

Cement hip arthroplasty in hemodialysis patients

Objective To observe the short-term results of hip arthroplasty in hemodialysis patients. Methods 11 hips in 9 patients receiving hemodialysis （range 3 months-13 years,average 8.6 years）for chronic renal failure were retrospectively reviewed.Osteonecrosis of the femoral head,rheumatoid arthritis,and fracture of femoral neck were treated by total hip arthroplasty （THA） or bipolar hemi-arthroplasty （BHA）using cement prosthesis.The average follow-up period was 4.4 years （range 2-9 years）. Results On average,the 4.4-year survival rate of prosthesis was 81.8%（9/llhips）,and the Harris hip scores was restored to 85.8 points postoperatively from 47.8 points preoperatively （3 cases/4 hips of osteonecrosis of the femoral head and 1 case/2 hips of rheumatoid arthritis）.The excellent and good rate was 77.8%（7/9 hips）. Conclusion Cement THA（include BHA）is a useful treatment option for patients on hemodialysis.