| 踝关节置换治疗血友病性关节炎的短期
临床疗效观察 |
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投稿时间：2009-03-03
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| 期刊信息：《中国骨伤》2009年，第22卷，第6期，第428-431页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：评估血友病性踝关节炎行关节置换治疗的短期疗效，讨论关节置换对患者生活质量及关节功能改善的主要方面及相关原因，积累更多的临床经验。
方法：自2004年7月至2007年7月由门诊收治确诊为甲型血友病性踝关节炎患者6例8踝，均为男性，年龄23～57岁，平均41.2岁，予踝关节置换，以Kofoed和AOFAS系统评价疗效，分别于术前及术后6、12个月进行评分比较。
结果：对于Kofoed评价系统，关节置换能显着改善术前、术后在疼痛、功能、活动度及总分方面的评分(P<0.05),除疼痛项外，其他3项又存在术后12个月和术后6个月评分的差异(P<0.05);在功能活动度的各项评分细类中，手术后均较术前有显着改变(P<0.05),而背伸功能在术后12个月的改善程度较术后6个月更加显着(P<0.05).对于AOFAS足-后踝评分系统，总分、疼痛、功能和力线方面的评分均存在手术前后的差异(P<0.05),但术后6个月和12个月的随访结果显示疼痛和力线没有显着改变(P>0.05),而总分和功能评分存在差异(P<0.05);在关节功能的各细类评分中，手术前后对比均有显着改善(P<0.05),而行走距离和屈伸活动存在6个月和12个月的随访差异(P<0.05).两个评分系统均显示关节置换术前后显着的疗效差异(P<0.05),而术后6个月及12个月随访结果提示其稳定性(P>0.05).
结论：短期观察，关节置换术可以显着缓解血友病性踝关节炎患者的临床症状，改善关节功能，随着适应性的提高和下肢肌力的进一步改善，患者的关节功能将平稳而长久地增强，体现出良好的治疗效果。 |
| 【关键词】关节成形术,置换 踝关节 血友病 关节炎 |
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| Study on short-term effects of ankle replacement for the treatment of hemophilic arthritis |
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ABSTRACT
Objective: To evaluate the short-term effects of ankle joint replacement for the patients with hemophilic arthritis. To find out the main points for improving the joint function and the patients' life quality. To accumulate more experience for clinical treatment.
Methods: The Kofoed evaluation system and the AOFAS evaluation system were used to follow-up 6 hemophilic patients with ankle arthritis(6 males,ranging in age from 23 to 57 years,with an average of 41.2 years),who were treated with ankle joint replacement from 2004.7 to 2007.7. The scores before operation,and the 6th,12th months after operation were compared.
Results: The Kofoed evaluation system showed the joint replacement significantly improved the scores for relieving pain,joint function,range of motion and the total score(P<0.05). Except the score for relieving pain,the other three also had significant differences between the 6th month and the 12th month after the operation(P<0.05). Compared with each details of the joint function,there was significant improvement before and after the operation(P<0.05). The ankle got more extended range of motion in the 12th month after operation than the 6th month(P<0.05). The AOFAS evaluation system showed the joint replacement significantly improved the scores for relieving pain,joint function,X-ray measurement and the total score(P<0.05). There was no differences between the 6th month after operation and the 12th month in the results for relieving pain and the X-ray measurement(P>0.05). However,the joint function and the total score had significant differences(P<0.05). Compared with each details of the joint function,there was also significant improvement before and after the operation(P<0.05),and the walk distance,as well as the joint flexion and extension activities,had differences between the 6th month and the 12th month after the operation. Both of the two evaluation system showed the operation could get good curative effects(P<0.05),and the artificial joint could constantly be in good condition from the 6th month to the 12th month after operation(P>0.05).
Conclusion: In this short-term observation,the joint replacement can significantly improve the life quality for the hemophilic patients with ankle arthritis. |
| KEY WORDS Arthroplasty,replacement Ankle joint Hemophilia Arthritis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 闵重函,张洪美.踝关节置换治疗血友病性关节炎的短期
临床疗效观察[J].中国骨伤,2009,22(6):428~431 |
| 英文格式: | MIN Zhong-han,ZHANG Hong-mei.Study on short-term effects of ankle replacement for the treatment of hemophilic arthritis[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(6):428~431 |
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