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目的 了解类风湿关节炎患者在接受全膝、全髋关节置换术时颈椎受累情况.方法 通过对46 例接受全膝、全髋置换术的类风湿关节炎患者的颈椎X线片( 包括侧位中立位及侧位过伸、过屈位) 的测量,了解寰枢椎的前后半脱位、垂直半脱位和下位颈椎半脱位的发生情况,以及手术时有无颈部症状的主诉,神经学检查是否异常等进行回顾性调查.结果 30 例患者(65.2％) 有颈椎X线异常的表现.颈椎受累的频率与病史的长短、类风湿关节炎的病型及多关节置换成正相关性.结论在这个选择性的类风湿人群中,有如此高的颈椎发病率,提示医师对类风湿关节炎患者行人工关节置换术时,在术前评价、术中麻醉及术后康复时应高度重视颈椎病变的存在.“,”Objective To analyze the roentgenographic records of 46 rheumatoid patients undergone total hip or knee arthroplasty. Methods The cervical spine roentgenographs were evaluated for significant atlantoaxial subluxation(AAS), atlantoaxial vertical subluxation(VS), subaxial subluxation(SAS).Results One or more than one roentgenographic findings were present in 30 (65.2%) cases of this series. Conclusion This high incidence of cervical spine instability in a selected population of rheumatoid patients emphasizes the importance of preoperative evaluation of the cervical spine and postoperative rehabilitations.