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非创伤性股骨头缺血性坏死患者病程对全髋关节置换术后疗效的影响
作者:
作者单位:

南京医科大学第一附属医院骨科

基金项目:

江苏省人民医院临床能力提升工程护理项目（JSPH-NB-2022-8）


Influence of the course of non-traumatic avascular necrosis of the femoral head on the outcome of total hip replacement
Author:
Affiliation:

Department of Orthopedics Surgery,the First Affiliated Hospital of Nanjing Medical University

Fund Project:

Jiangsu Provincial People's Hospital Clinical Competency Enhancement Project - Nursing Program (JSPH-NB-2022-8)

  • 摘要
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  • 参考文献 [34]
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    摘要:

    目的：探究非创伤性股骨头缺血性坏死患者病程长短对人工全髋关节置换术(Total Hip Arthroplasty,THA)后患者疼痛、功能恢复及生活质量的影响。方法：回顾性分析2022年9月至2024年3月诊断为ARCOIII、IV期股骨头缺血性坏死于南京医科大学第一附属医院行THA治疗的患者。根据患者病程的长短分为短病程组(病程≤3年)与长病程组(病程＞3年)。对比两组患者手术时长、住院时间、总失血量、术前术后的VAS疼痛评分、髋关节Harris功能评分、双下肢不等长(Leg Length Discrepancy,LLD)、臀中肌肌肉脂肪浸润程度(Muscle Fat Infiltration, MFI)、骨盆倾斜角度(Pelvic Obliquity Angle,POA)以及术后并发症发生率。结果：共纳入219例患者,短病程组149例,长病程组70例。与短病程组相比,长病程组患者住院时长久(P＜0.05)、手术时间长(P＜0.01),总失血量多(P＜0.05),术前及术后3天、5天、1月的VAS疼痛评分高(P＜0.05),术后1月、3月髋关节Harris评分低(P＜0.01),术前双下肢不等长明显(P＜0.01)、臀中肌MFI大(P＜0.01)、术前术后骨盆倾斜角大(P＜0.01),而在术后3月疼痛VAS评分、术后6月髋关节Harris评分、双下肢不等长及术后并发症方面,两组患者差异无统计学意义(P＞0.05)。结论：与病程长的患者相比,病程短的患者在接受THA治疗后短期内疼痛及髋关节功能恢复情况较好。

    Abstract:

    Objective: This study aims to explore the impact of the course of non-traumatic osteonecrosis of the femoral head (ONFH) on pain, functional recovery and quality of life after total hip arthroplasty (THA). Methods: Patients undergoing THA treatment at the First Affiliated Hospital of Nanjing Medical University from September 2022 to January 2024 due to terminal ONFH were retrospectively analyzed. Patients were divided into short course group (course of disease ≤3 years) and long course group (course of disease>3 years) according to the length of the course of disease. Compare the duration of surgery, hospital stay, total blood loss, preoperative and postoperative pain VAS scores, hip joint function Harris scores, Leg Length Discrepancy (LLD), Muscle Fat Infiltration (MFI), Pelvic Obliquity Angle (POA), and the incidence of postoperative complications between two groups of patients. Results：A total of 219 patients were included, 149 patients were in the short course group and 70 patients were in the long course group. Compared to the short disease duration group, patients in the long disease duration group exhibited longer operative times(P＜0.05) and hospital stays (P＜0.01), greater total blood loss (P＜0.05), higher Visual Analogue Scale (VAS) pain scores preoperatively and at postoperative days 3, 5, and 1 month (P＜0.05), and lower Harris hip scores at 6 weeks and 3 months postoperatively (P＜0.05). Additionally, there was a greater preoperative LLD、MFI and larger preoperative and postoperative Pelvic Obliquity Angles in the long disease duration group(P＜0.05). However, there was no significant difference between the two groups in pain VAS score 3 months after operation, hip Harris score 6 months after operation, leg length discrepancy and postoperative complications (P＞0.05).

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  • 收稿日期:2024-11-04
  • 最后修改日期:2024-12-31
  • 录用日期:2025-02-21

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