骨水泥型人工半髋与全髋关节置换对老年严重髋关节疾病患者ESR CRP及SAA水平的影响比较

摘要

目的:对比骨水泥型人工全髋与半髋关节置换对老年严重髋关节疾病患者血清红细胞沉降率(ESR)、C反应蛋白(CRP)及淀粉样蛋白A(SAA)水平的影响.方法:研究选取2013年1月至2016年6月在我院接受人工髋关节置换的124例老年严重髋关节疾病患者,其中行骨水泥型人工半髋关节置换治疗的患者56例,行骨水泥型人工全髋关节置换治疗的患者68例.对比两组手术相关指标、治疗前后髋关节Harris评分及血清ESR、CRP、SAA水平变化情况.结果:半髋关节置换组置换时间、术中出血量、术后引流量、术后活动时间、住院时间均显著低于全髋关节置换组(P＜0.01),两组并发症发生率对比无明显差异(P＞0.05);半髋关节置换组术后1、3、7、14d血清ESR、CRP、SAA水平均明显低于同时点全髋关节置换组(P＜0.05);两组间术前、术后3个月髋关节Harris评分对比无明显差异(P＞0.05).结论:骨水泥型人工半髋关节置换治疗老年严重髋关节疾病的疗效与骨水泥型人工全髋关节置换相近,但骨水泥型人工半髋关节置换术后炎症反应更轻,手术创伤更小,患者耐受性更好,故更适宜于一般状况较差的老年患者.%Objective:To compare the effects of total hip arthroplasty and hemiarthroplasty on serum erythrocyte sedimentation rate (ESR),C reactive protein (CRP) and amyloid A (SAA) levels in elderly patients with severe hip disease.Methods:124 elderly patients with severe hip disease who underwent artificial hip replacement in our hospital from January 2013 to June 2016 were selected.Among them,56 patients received bone cement artificial hip replacement and 68 cases were treated with bone cement artificial total hip arthroplasty.Then surgical related indicators,hip Harris score,the changes of serum ESR,CRP and SAA levels of the two groups before and after the treatment were compared.Results:Replacement time,intraoperative blood loss,postoperative drainage volume,postoperative activity time and hospitalization time of the hemiarthroplasty group were significantly lower than that of the total hip replacement group (P＜0.01),there was no significant difference in complication rate between the two groups (P＞0.05);the levels of serum ESR,CRP and SAA of 1,3,7 and 14d of the hemiarthroplasty group were significantly lower than those of the total hip replacement group of the same time period (P＜0.05);There was no significant difference in hip Harris score between the two groups before and 3 months after the surgery (P＞0.05).Conclusion:The effect of bone cement type artificial hip joint replacement cementless hemiarthroplasty is similar to the bone cement type artificial hip replacement in the treatment of elderly patients with severe hip joint diseases.But cemented hip replacement has lighter inflammation,less surgical trauma,with better patients'tolerablity,so it is more suitable for elderly patients with poor general condition.