| 关节镜手术治疗强直性脊柱炎髋关节早期病变的中期临床效果分析 |
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Received:August 12, 2016
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| 作者 | Author | 单位 | Unit | E-Mail |
| 李春宝 |
LI Chun-bao |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 齐玮 |
QI Wei |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 王志刚 |
WANG Zhi-gang |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
wzhigang301@sohu.com |
| 李众利 |
LI Zhong-li |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 魏民 |
WEI Min |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 蔡谞 |
CAI Xu |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 张强 |
ZHANG Qiang |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 朱娟丽 |
ZHU Juan-li |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 刘洋 |
LIU Yang |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
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| 刘玉杰 |
LIU Yu-jie |
解放军总医院骨科, 北京 100853 |
Department of Orthopaedics, PLA General Hospital, Beijing 100853, China |
13701356381@163.com |
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| 期刊信息：《中国骨伤》2017年30卷，第3期，第236-240页 |
| DOI：10.3969/j.issn.1003-0034.2017.03.010 |
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目的：探讨对强直性脊柱炎髋关节早期病变进行麻醉下推拿活动联合关节镜清理手术治疗的效果。
方法：2011年6月至2013年6月采用全身麻醉下推拿活动及关节镜下探查清理、滑膜切除、软骨修整手术治疗22 例强直性脊柱炎髋关节早期病变患者，其中男6例，女16例；年龄17～35岁，平均24.7岁；病程10～41个月，平均22.1个月。经6个月正规保守治疗髋部受限疼痛等症状无缓解。通过患侧髋关节活动度、VAS疼痛评分、mHHS评分、NAHS评分对比进行术前和术后随访评估。
结果：全部患者获随访，时间26～44个月，平均30.2个月。患髋屈伸、内收外展、伸直位及屈曲90°位的内外旋角度范围分别由术前的（78.2±10.2）°、（36.3±6.4）°、（31.1±9.2）°及（37.3±10.5）°升至术后的（113.5±8.4）°、（55.7±8.4）°、（58.7±2.1）°及（60.1±9.8）°；VAS 评分由术前的8.5±9.4 降至术后的5.5±7.1；改良的Harris 和 NAHS评分分别由术前的 60.8±6.9 及 56.9±6.25 升至术后的 88.1±10.4及 84.6±5.4.
结论：全身麻醉下髋关节推拿活动及关节镜手术能够有效恢复强直性脊柱炎髋关节病变患者的关节活动度，减轻疼痛症状，延缓关节畸形及强直，具有出血少、恢复快等优势，能显着改善患者生活质量。 |
| [关键词]:关节镜 脊柱炎，强直性 髋关节 |
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| Midterm clinical outcome for ankylosing spondylitis patients with early hip-involved diseases treated with arthroscopic technique |
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Abstract:
Objective: To study the clinical outcome of manipulation release combined with arthroscopic debridement and synovia resection under general anesthesia for early hip involvment in patients with ankylosing spondylitis.
Methods: Manipulation release combined with arthroscpic debridement and synovium resection were performed for hip lesion in 22 patients with ankylosing spondylitis from June 2011 to June 2013,incuding 6 males and 16 females with anverage age of 24.7 years ranging from 17 to 23 years. The course of the diseases was from 10 to 41 months(22.1 months on average). After 6 months of conservative treatment,hip pain and other symptoms were no relief. The preoperative and postoperative follow-up evaluation was performed and compared by the hip movement,VAS pain score,mHHS score and NAHS score.
Results: All the patients were followed up for 26 to 44 months with an average of 30.2 months. The range of motion in active flexion-extension,abduction-adduction,internal-external rotation in 0° flexion and 90° flexion increased from(78.2±10.2)°，(36.3±6.4)°，(31.1±9.2)° and(37.3±10.5)° before operation to(113.5±8.4)°，(55.7±8.4)°，(58.7±2.1)° and(60.1±9.8)° after operation,respectively. The VAS scores decreased from 8.5±9.4 before operation to 5.5±7.1 after operation. The modified Harris and NAHS scores increased from 60.8±6.9 and 56.9±6.25 before operation to 88.1±10.4 and 84.6±5.4 after operation,respectively.
Conclusion: Manipulation release combined with arthroscopic debridement and synovium resection under general anesthesia could effectively control the progression of hip lesion in patients with ankylosing spondylitis restoring the ROM,relieve pain symptoms,delay joint deformity and ankylosis with less bleeding,faster recovery,and significantly improve patients' quality of life. |
| KEYWORDS:Arthroscopes Spondylitis,ankylosing Hip joint |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 李春宝,齐玮,王志刚,李众利,魏民,蔡谞,张强,朱娟丽,刘洋,刘玉杰.关节镜手术治疗强直性脊柱炎髋关节早期病变的中期临床效果分析[J].中国骨伤,2017,30(3):236~240 |
| 英文格式: | LI Chun-bao,QI Wei,WANG Zhi-gang,LI Zhong-li,WEI Min,CAI Xu,ZHANG Qiang,ZHU Juan-li,LIU Yang,LIU Yu-jie.Midterm clinical outcome for ankylosing spondylitis patients with early hip-involved diseases treated with arthroscopic technique[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(3):236~240 |
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