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目的 寻求检查非骨水泥全髋置换 (THR CL)手术前后骨密度 (BMD)变化的最佳方法。方法 采用双能X线骨密度仪 (DEXA)与常规X线摄片对 7例手术前、后以及术后 1～ 3年内的近段股骨各兴趣区BMD进行检测和比较。结果 DEXA定量显示 1、5、6区术后BMD增加 ,其中 1区增加显著 (10 42 % ) ,2、3、4、7区减少 ,其中 7区减少显著 (16 5 % )。术后 1年内BMD在 6、7区呈持续显著减低 4 4%～ 5 6 % ,在 3、4、5区呈持续显著增高 6 2 %～ 6 6 % ,而 1、2区仅轻微减少1 3%～ 1 8% ,术后 2～ 3年BMD改变轻微。相比之下 ,手术前、后X线摄片均未能显示任何BMD差异 ,更未能定量显示。结论 DEXA具有辐射量低、敏感性强、重复检查误差小和定量正确性高等优点。手术前、后各区BMD变化对评价THR CL股骨头假体固定质量的意义。
Objective To seek the best method to check the change of bone mineral density (BMD) before and after THM CL surgery. Methods Bone mineral density (DEXA) and conventional radiography were used to detect and compare the BMD of seven proximal femur regions before and after surgery and within 1-3 years after operation. Results The quantitative analysis of DEXA showed that the BMDs increased in the first, the fifth and the sixth postoperatively. There was a significant increase (P <0.05) in the 1st and the 4th, 4th, 4th and 7th districts. Within 1 year after operation, the BMD decreased significantly from 44% to 56% in the 6th and 7th districts, and continued to increase from 62% to 66% in the 3rd, 4th, and 5th districts, while only slightly decreased in the 1st and 2nd districts 3% ~ 18%, 2 to 3 years after the BMD change slightly. In contrast, before and after X-ray radiography failed to show any BMD differences, but failed to quantitative display. Conclusion DEXA has the advantages of low radiation dose, high sensitivity, small error of repeated examination and high quantitative accuracy. The significance of BMD changes before and after operation in evaluating the fixed quality of THR CL femoral head prosthesis.