人工股骨头置换术联合早期功能锻炼在股骨头坏死患者中的应用效果
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摘要
目的探讨人工股骨头置换术联合早期功能锻炼在股骨头坏死患者中的应用效果。方法选取峨眉山市人民医院2013年1月—2016年1月收治的股骨头坏死患者90例,按照床号随机分为对照组与观察组,每组45例。对照组患者予以传统复位内固定手术治疗,观察组患者予以人工股骨头置换术治疗联合早期功能锻炼。比较两组患者手术前后髋关节功能评分标准(Harris)评分、术后视觉模拟评分法(VAS)评分,并观察两组患者并发症发生情况。结果术前两组患者Harris评分比较,差异无统计学意义(P>0.05);术后3、6个月观察组患者Harris评分高于对照组(P<0.05)。术后6 h、3 d、7 d观察组患者VAS评分低于对照组(P<0.05)。观察组患者并发症发生率低于对照组(P<0.05)。结论人工股骨头置换术联合早期功能锻炼在股骨头坏死患者中的应用效果良好,利于患者术后肢体功能恢复,且安全性高。
Objective To study the application effect of artificial femoral head replacement combined with early functional exercise in patients with osteonecrosis of femoral head.Methods A total of 90 cases of patients with osteonecrosis of femeral head were selected from January 2013 to January 2016 in Emeishan people's Hospital,which were divided into control group and observation group according to the bed number,45 cases in each group.The control group was treated by a traditional reduction internal fixation operation,the observation group was treated with artificial femoral head replacement combined with early functional exercise.Harris score before and after operation,VAS score after operation were compared between the two groups,and the incidence of complications were observed.Results There was no significant difference in Harris score between the two groups before operation(P>0.05).3,6 months after operation,the Harris score of the observation group was higher than control group.6 h,3 d,7 d after operation,VAS scores in the observation group was lower than control group(P<0.05).The incidence rate of complications in the observation group was lower than control group(P<0.05).Conclusion Artificial femoral head replacement combined with early functional exercise have an exact clinical effect for osteonecrosis of femoral head,it is beneficial to the recovery of limb function after operation,and with high safety.
Objective To study the application effect of artificial femoral head replacement combined with early functional exercise in patients with osteonecrosis of femoral head.Methods A total of 90 cases of patients with osteonecrosis of femeral head were selected from January 2013 to January 2016 in Emeishan people's Hospital,which were divided into control group and observation group according to the bed number,45 cases in each group.The control group was treated by a traditional reduction internal fixation operation,the observation group was treated with artificial femoral head replacement combined with early functional exercise.Harris score before and after operation,VAS score after operation were compared between the two groups,and the incidence of complications were observed.Results There was no significant difference in Harris score between the two groups before operation(P>0.05).3,6 months after operation,the Harris score of the observation group was higher than control group.6 h,3 d,7 d after operation,VAS scores in the observation group was lower than control group(P<0.05).The incidence rate of complications in the observation group was lower than control group(P<0.05).Conclusion Artificial femoral head replacement combined with early functional exercise have an exact clinical effect for osteonecrosis of femoral head,it is beneficial to the recovery of limb function after operation,and with high safety.
引文
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[14]马慧勇,曹江龙,李旭晨,等.股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死的相关因素[J].中国老年学杂志,2015,35(4):988-989.
[15]MEAGER MD,VOLLMAR B.Surgical trauma:hyperinflammation versus immunosuppression[J].Langenbecks Arch Surg,2004,389(6):475-484.
[2]冯晓飞,张建军,张小栋,等.两种人工髋关节置入治疗缺血性股骨头坏死的效果比较[J].西南国防医药,2016,26(7):723-725.
[3]朱建炜,刘璠,董启榕,等.中青年髋关节疾病行金属对金属全髋关节表面置换术的疗效及安全性[J].山东医药,2014,54(1):11-13.
[4]王仁,禹晓东,许向东,等.全髋关节置换术治疗股骨头坏死326髋疗效分析[J].实用医学杂志,2013,29(14):2353-2355.
[5]孙振辉,刘军,曹建刚,等.全膝关节置换术后股骨颈骨折的临床处理[J].中华医学杂志,2011,91(15):1026-1030.
[6]RITTNER H L,MACHELSKA H,STEIN C.Leukocytes in the regulation of pain and analgesia[J].J Leukoc Biol,2005,78(6):1215-1222.
[7]寇宏斌,陈安记.中西药及早期肢体功能锻炼治疗老年髋部骨折术后患者108例[J].陕西中医,2008,29(9):1196,1237.
[8]赵婧.影响骨科住院患者早期功能锻炼依从性原因与对策[J].中国实用护理杂志,2015,31(z2):45.
[9]BASTIAN D,SHEGARFI H,ROLSTAD B,et a1.Investigation of lipopolysaccharide receptor expression on human monocytes after major orthopaedic surgery[J].Eur Surg Res,2008,40(2):239-245.
[10]周锦春,郭敦明,王青,等.股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死多中心多因素相关分析[J].中华骨科杂志,2013,33(5):549-554.
[11]谢康,高维陆,常俊,等.股骨颈骨折修复后股骨头坏死7个相关因素:199例回顾分析[J].中国组织工程研究,2016,20(24):3529-3534.
[12]BEILIN B,RUSABROV Y,SHAPIRA Y,et al.Low-dose ketamine affects immune responses in humans during the early postoperative period[J].Br J Anaesth,2007,99(4):522-527.
[13]丁福鹏,戚长林,高辉,等.外周血滤泡辅助性T细胞与B细胞在酒精性股骨头坏死患者中的作用[J].中国免疫学杂志,2015,31(8):1109-1112,1119.
[14]马慧勇,曹江龙,李旭晨,等.股骨颈骨折闭合复位加压螺纹钉内固定术后股骨头坏死的相关因素[J].中国老年学杂志,2015,35(4):988-989.
[15]MEAGER MD,VOLLMAR B.Surgical trauma:hyperinflammation versus immunosuppression[J].Langenbecks Arch Surg,2004,389(6):475-484.