人工髋关节置换术在320例股骨头缺血性坏死中的治疗体会

目的：探讨人工髋关节置换术在治疗股骨头缺血性坏死（ANFH）中的临床疗效。方法：选择2007年2月-2011年2月我院收治的320例（340髋）股骨头缺血性坏死患者，均采用人工髋关节置换术对患者进行治疗，其中160例（172髋）患者应用骨水泥型假体进行治疗，另外160例（168）患者采用非骨水泥型假体进行治疗。采用Harris评分对患者手术前后的髋关节功能情况进行评价，并比较骨水泥治疗组和非骨水泥治疗组的临床疗效。结果：患者均获得随访，随访时间为3～18个月。全部患者手术后的Harris评分明显高于手术前，差异有统计学意义（P〈0．05）。骨水泥治疗组和非骨水泥治疗组在术后出血量、术后Harris评分及住院时间方面的差异无统计学意义（P〉0．05），但非骨水泥治疗组的并发症发生率明显低于骨水泥治疗组（P〈0．05）。结论：采用人工髋关节置换术治疗ANFH疗效显著，能明显改善患者的生活质量，骨水泥型假体与非骨水泥型假体的治疗效果相当，应根据患者的具体情况进行合理的选择。

Hip Replacement Surgery for 320 Cases of Avascular Necrosis of Femoral Head

Objective： To investigate the clinical efficacy of hip replacement surgery in the treatment of avascular necrosis of femoral head （ANFH）. Methods： 320 cases （340 hips） in patients with avascular necrosis of femoral head from February 2007 to February 2011 in our hospital were selected and given artificial hip replacement surgery for treatment, of which 160 cases （172 hips） were used of bone cement prosthesis for treatment, and 160 cases （168 hips） were treated with uncemented prosthesis for treatment. Using the Harris hip score to evaluate and compare the clinical efficacy of bone cement treated and non-bone cement treated before and after surgery. Results： The patients were followed up for 3 to 18 months. All patients with post-operative Harris hip score was significantly higher than before the surgery, the difference was statistically significant （P〈0.05）. Bone cement treatment group and the non-bone cement treated group had no significant differences in postoperative bleeding, postoperative Harris hip score and hospitalization time （P〉 0.05）, but nonbone cement treated group had significantly lower incidence of complications than the bone cement treated group （P 〈0.05）. Conclusion： The artificial hip arthroplasty had significant effect on ANFH, and it could significantly improve the patient＇s quality of life. The bone cement prosthesis and non-bone cement prosthesis showed equal effect, so we should make reasonable choice based on the patient＇s specific circumstances.