目的 探讨系统性红斑狼疮(SLE)激素治疗导致股骨头坏死行全髋关节置换术患者的围手术期特殊处理方法.方法 对12例(14髋)SLE并发股骨头缺血性坏死患者在病情稳定、SLE无活动时进行人工全髋关节置换术,术中补充小剂量激素,术前3 d及术后7 d使用抗生素,围手术期继续治疗SLE.结果 12例患者围手术期病情平稳,2例出现SLE活动,1例切口愈合不良,无发生肾上腺皮质危象.患者术后均获随访,时间2~3年,无感染发生.结论 激素治疗后股骨头坏死的SLE患者行人工全髋关节置换术围手术期应特别注意病情及药物使用,尤其是激素、抗生素的使用和原发病的治疗.%Objective To study the treatment during the operation of total hip arthroplasty in systemic lupus erythematosus ( SLE ) patients. Methods Total hip replacement was performed in 12 patients ( 14 hips ) of SLE with femoral head necrosis when the condition was stable. They were given small doses of glucocorticoid intraoperatively, and antibiotics from three days preoperatively to seven days postoperative^. No treatment interrupted for the SLE. Results All the patients were stable perioperativety. However, two patients were found for SLE activity, and one patient was with poor wound healing. No patient occurred adrenal crisis. The patients were followed up for 2-3 years,with no cases of infection. Conclusions The lupus patients with long-term use of glucocorticoid should be cared especial-ly about the condition and drug perioperatively, including the use of glucocorticoid and antibiotics,with the treatment of the primary disease.
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