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style=\"text-indent:2em\">股骨头坏死的预防：</p><p style=\"text-indent:2em\"><br/></p><p style=\"text-indent:2em\">避免滥用肾上腺皮质激素类药物，如倍他米松、倍氯米松、强的松等。目前，激素滥用现象仍很普遍，甚至感冒、发热及关节痛都用激素，这无疑增加了股骨头缺血性坏死发生的几率。必须使用激素时，应遵循短期、适量原则。大剂量给药，即使是短期用药，也可能诱发股骨头坏死。</p><p style=\"text-indent:2em\"><br/></p><p style=\"text-indent:2em\">酒精性股骨头坏死的预防在于减少饮酒，避免酗酒，可少量多餐。</p><p style=\"text-indent:2em\"><br/></p><p style=\"text-indent:2em\">工作生活中，应多加小心，加强髋部的自我保护意识，避免外伤。在体育活动或扛、背重物时，要避免髋部扭伤，尽量不要干过重的活。</p><p><br/></p>","barId":"1794","topicTypeId":null,"topicThemeId":"1036","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"2246","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"股骨头坏死的锻炼方法","content":"<p style=\"text-indent: 2em\">股骨头坏死的患者是一定要注意休息的，但是并不是长期的卧床休息，这对康复也是很不利，那日常就要注意一些锻炼了，在活动锻炼的过程中，又有很多的原则需要注意，下面对康复锻炼的原则给您详细的介绍！</p><p style=\"text-indent: 2em\"><br/></p><p style=\"text-indent: 2em\"><strong>股骨头坏死患者如何锻炼？</strong>股骨头坏死的锻炼应该遵循以下这些原则：</p><p style=\"text-indent: 2em\"><br/></p><p style=\"text-indent: 2em\">1、进行功能的锻炼，这应该在接受相关的治疗，病情稳定之后，然后再采取相关的锻炼措施，而且在专业医护人员指导下进行，否则会加重股骨头的破坏。</p><p style=\"text-indent: 2em\"><br/></p><p style=\"text-indent: 2em\">2、进行功能锻炼，不可操之过急，要循序渐进，一步一步的来，尽量是选择一些缓慢的锻炼！</p><p style=\"text-indent: 2em\"><br/></p><p style=\"text-indent: 2em\">3、如果在进行相关锻炼的时候，出现了磨擦音，或者是有轻微的疼痛之感，这其实都是正常的，稍事休息就会缓解；但如果疼痛剧烈，则应适当减少活动次数和活动幅度。</p><p style=\"text-indent: 2em\"><br/></p><p style=\"text-indent: 2em\">4、功能锻炼动作不要过猛，主动锻炼为主、被动为辅，而且在锻炼的时候，要根据期、形、髋关节周围软组织的功能受限程度以及体质，选择适宜的坐、立、卧位锻炼方法。</p><p style=\"text-indent: 2em\"><br/></p><p style=\"text-indent: 2em\">5、在进行锻炼的时候，也得要分型进行，如果是崩解型或出现断裂带的患者，那在锻炼的过程中，就要注意使用拐杖了，活动中应避免突然的旋转动作，防止股骨头及髋臼出现扭矩或剪切力，待断裂带修复后，可在医生指导下练功。</p><p style=\"text-indent: 2em\"><br/></p><p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 对股骨头坏死患者应该如何进行锻炼，在上述的文章中，主要就为大家介绍这些治疗的原则了，看完以上内容的整理，希望患者在进行相关锻炼的时候，注意一些事项，这样更好的帮助康复！</p><p><br/></p>","barId":"1794","topicTypeId":null,"topicThemeId":"1035","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"3553","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"抚州第一人民医院洪华因误诊误治 致髋关节置换患者饱受摧残离世","content":"<span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp; &nbsp;&nbsp; </span><span style=\"font-size: 19px;line-height:200%\">邱裕芳，原中共党员，在江西抚州市委、市府工作多年，于上世纪80年代为壮大临川教育事业、弘扬临川文化，撰写了由中央电视台投拍的电视剧剧本《呼唤》，并获华东地区“银燕奖”，得到省内各界及时任市委市政府领导的高度评价，是上世纪90年代抚州市被省委宣传部评聘的为数不多的高级政工师，最后在市商务局退休。邱裕芳膝下有一爱女，在抚州市第二人民医院工作，深受患者喜爱，在工作中因表现突出多次被医院及相关单位表彰。而且对父亲也很孝顺，邱裕芳老人一家也因此备受周围邻居羡慕。谁曾想，2012年邱裕芳老人因遭遇一场误诊误治，健康器官被非法切除，并被扔进垃圾桶。这个原本幸福和睦家庭从此备受煎熬、以泪洗面。</span><p style=\"text-align:center\"><span style=\"font-size: 19px; line-height: 200%;\"><img src=\"http://01luntan.com/ly_img/uimgs/1488330017086.gif\" title=\"1488330017086.gif\" alt=\"006r20Ynly1fd6hnj0a9gg30p00dw7e1.gif\" width=\"492\" height=\"297\"/></span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">邱裕芳老人主要工作成就</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">下面找良医网根据邱裕芳之女提供材料再现事件经过：</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; 1</span><span style=\"font-size:19px;line-height:200%\">、患者抚州市第一人民医院骨科洪华诊断为“右侧股骨头缺血性坏死”。并保证“手术后半个月保证可以下地行走”！被夸大的疗效成功换取患者的信任并办理住院，拟进行右侧髋关节置换手术。</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 2</span><span style=\"font-size:19px;line-height:200%\">、由在家属反映镇痛泵副反应极大情况下，没采取任何措施。相关医生给患者加静滴一支强效类阿片镇痛药对患者更是雪上家属。一连串的错误治疗，致使患者处于重度昏睡、全身重度水肿、身体重要脏器重度受损，下达病危通知书。对每次用药后出现极大副反应，涉事医生洪华竟然不负责任地对家属说到“其实我是不主张用这药的”！</span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\"><img src=\"http://01luntan.com/ly_img/uimgs/1488330575173.jpg\" title=\"1488330575173.jpg\" alt=\"006r20Ynly1fd6hpv9f6lj30jg0elai4.jpg\"/></span></p><p style=\"line-height: 200%; text-align: center;\"><span style=\"font-size:19px;line-height:200%\">患者昏睡8天</span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp;<img src=\"http://01luntan.com/ly_img/uimgs/1488330376721.jpg\" title=\"1488330376721.jpg\" alt=\"006r20Ynly1fd6hqnfysij30np0hswsv.jpg\"/></span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">全身重度水肿，致使血管无处可注射</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%;font-family:&#39;MS Mincho&#39;\"></span><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp; &nbsp; &nbsp; 3</span><span style=\"font-size:19px;line-height:200%\">、患者昏睡8个昼夜期间，患者家属屡次向经管和主管医生反应患者呼吸非常急促、吞咽非常困难等不良情况，得到的回答居然是“这样没事的，先把脑子醒了再说吧！”特别是在出现上述症状情况下，<strong><span style=\"color:#D24A35\">主管医生及经管医生居然要患者家属用轮椅推到户外“透透风醒醒脑”！实在难以想象此种偏远山村卫生所都不可能做的事情居然出现在三甲医院！</span></strong></span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp; &nbsp;&nbsp; 4</span><span style=\"font-size:19px;line-height:200%\">、术后50多天，患者实施置换的右侧髋关节因脱位突然剧烈疼痛，几近休克，拨通主刀医生洪华的电话，洪上门进行简单人工复位，次日中午再次出现脱位，患者虽然遭受几次人工强行复位的折磨，也未能成功，二度在手术室进行麻醉人工复位，第四日假体再次脱位，脱位！脱位！脱位！四天三次脱位！！！</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 5</span><span style=\"font-size:19px;line-height:200%\">、患者及家属最后请到省一附院的骨科权威戴闽主任到抚州进行髋关节翻修手术。戴闽主任使用的股骨柄是6号加粗加长型号，而洪华在第一次手术时使用的股骨柄是4号。</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp; &nbsp; &nbsp; 6</span><span style=\"font-size:19px;line-height:200%\">、在第一人民医院住院期间，护理不力，导致患者感染褥疮，而这一点在任何一家医院是绝对不允许发生的事情。</span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\"><img src=\"http://01luntan.com/ly_img/uimgs/1488330315694.jpg\" title=\"1488330315694.jpg\" alt=\"006r20Ynly1fd6hs6up52j30jg0eldi8.jpg\"/></span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">住院期间感染褥疮</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%;font-family:&#39;MS Mincho&#39;\"></span><span style=\"font-size:19px;line-height:200%\"> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 7</span><span style=\"font-size:19px;line-height:200%\">、患者家属通过多方努力，将患者术前X光片送到全国骨科最权威的北京积水潭医院请专家会诊，得到的结论令人<strong>十分震惊</strong>，患者被确诊为“类风湿性髋关节炎”，而不是“右侧股骨头缺血性坏死”，<strong>专家建议用生物制剂保守治疗，</strong>至此第一人民医院误诊误治已是铁打事实！</span></p><p style=\"line-height:200%\"><strong><span style=\"font-size:19px;line-height:200%;color:#D24A35\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 8</span></strong><strong><span style=\"font-size:19px;line-height:200%;color:#D24A35\">、洪华医生在术中暴露出股骨头后，在肉眼能观察到股骨头没有塌陷，已经明确仅是炎症非股骨头坏死情况下，仍未经过患者及家属同意，将错就错恶意将健康器官摘除。洪华在公安局委托的司法鉴定听证会上陈述：“患者是类风湿关节炎发展到后期就是股骨头坏死，就必须要做置换手术”。</span></strong><span style=\"font-size:19px;line-height:200%\">类风湿发展到后期就是股骨头坏死没有任何医学依据！！！<strong>洪华医生的陈述更加印证了医方医德缺失、颠倒黑白、严重违背法律法规的强盗逻辑和做法以及主观故意情节！ </strong></span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp; &nbsp;&nbsp; 9</span><span style=\"font-size:19px;line-height:200%\">、据患者家属诉说，相关人在术后立即令护士到患者病房将锯下的股骨头取走，家属之后通过多方寻找，在与病房相隔甚远的某垃圾桶中找到，这无疑是在毁灭证据。且违反医疗常规故意不做病理检验，以达到将错隐瞒到底的目的。</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 10</span><span style=\"font-size:19px;line-height:200%\">、在救治期间，抚州市第一人民医院方面逐步不闻不问，并停止开具正常治疗用药，声称只有抢救才能用药！最后责令出院，并于几个月后由骨二科偷偷私自结清住院费用瞒天过海。</span></p><p style=\"line-height:200%\"><strong><span style=\"font-size:19px;line-height:200%\">针对本误诊误治医疗事故相关权威观点：</span></strong></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">1</span><span style=\"font-size:19px;line-height:200%\">、江西天剑司法鉴定中心司法鉴定意见明确指出：</span></p><p style=\"line-height:200%\"><strong><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;</span></strong><strong><span style=\"font-size:19px;line-height:200%\">（1）患者属于款关节炎病变，诊断股骨头坏死依据不足，属于误诊，亦没有达到终末期关节炎，需要进行THA的程度，属于误治。（见下图）</span></strong></p><p style=\"line-height:200%\"><strong><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;</span></strong><strong><span style=\"font-size:19px;line-height:200%\">（2）医方给患者手术暴露出股骨头后，应能肉眼能观察出股骨头有无塌陷，应如实告诉患者家属征求意见，但医方没有告知患者家属。（见下图）</span></strong></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\"><img src=\"http://01luntan.com/ly_img/uimgs/1488330685002.jpg\" title=\"1488330685002.jpg\" alt=\"006r20Ynly1fd6hwck6mej31kw131e81.jpg\"/></span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">江西天剑司法鉴定中心鉴定意见</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;2</span><span style=\"font-size:19px;line-height:200%\">、受公安机关委托，江西求实司法鉴定中心也明确指出医方诊断股骨头坏死依据不足，属于误诊误治 。</span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\"><img src=\"http://01luntan.com/ly_img/uimgs/1488330645179.jpg\" title=\"1488330645179.jpg\" alt=\"006r20Ynly1fd6hxdf6v9j30pu0ejdj8.jpg\"/></span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">两家鉴定意见书一致认为本起事故为误诊误治</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;3</span><span style=\"font-size:19px;line-height:200%\">、北京积水潭医院骨科的专家确诊患者是右髋关节炎，建议用生物制剂保守治疗。至此，邱裕芳老人遭受误诊误治更是确定无疑。</span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\"><img src=\"http://01luntan.com/ly_img/uimgs/1488330367987.jpg\" title=\"1488330367987.jpg\" alt=\"006r20Ynly1fd6hzmxocxj30pu0jdwhz.jpg\"/></span></p><p style=\"text-align:center;line-height:200%\"><span style=\"font-size:19px;line-height:200%\">积水潭医院权威专家诊断</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%;font-family:&#39;MS Mincho&#39;\"></span><span style=\"font-size:19px;line-height:200%\"> &nbsp; &nbsp; &nbsp; &nbsp; 4</span><span style=\"font-size:19px;line-height:200%\">、在患者重度昏睡、全身重度水肿、身体重要脏器重度受损、更完成手术不久情况下，让患者家属抬着父亲坐轮椅到室外“透透风、醒醒脑”！后患者家属通过一些书籍和资料及骨科专家的分析得知，术后下地、侧身、脚点地都是有非常严格的护理规程的，特别是生物型的全髋置换下地时间应该在术后更长时间后进行！他们这样指导是完全违反规程和严重的失误！</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span><span style=\"font-size:19px;line-height: 200%\">针对本起误诊误治医疗纠纷，北京市华卫律师事务所资深律师邓力强认为：刑法第335条规定医疗事故罪，是指医务人员由于严重不负责任，造成就诊人死亡或者严重损害就诊人身体健康的行为。如果医疗工作人员是故意将病人致伤，则不构成医疗事故罪而构成故意伤害罪。<span style=\"color:#D24A35\">本案中，洪华医师在该起事故中因术中肉眼看得出误诊，但将错就错继续手术，存在主观故意。即行为人明知患者会造成损害，但仍然放任或希望这种结果发生，已构成故意伤害行为。</span></span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;&nbsp;&nbsp;&nbsp; </span><span style=\"font-size:19px;line-height: 200%\">邱裕芳老人在历尽人间地狱之痛，遭受常人难以忍受的痛苦之后不幸离世，<strong>六</strong>年了，他的家人不仅要承受丧夫、丧父之痛，在维权的路上不得不一次次再现老人痛苦，一次次揭开痛的伤疤。采访结束之际，我们非常欣慰的得到如下消息：邱裕芳老人的不幸遭遇得到省卫生厅、市政府、市卫生局等相关领导的高度重视。</span></p><p style=\"line-height:200%\"><span style=\"font-size:19px;line-height:200%\">&nbsp; &nbsp;</span><span style=\"font-size:19px;line-height: 200%\">&nbsp;&nbsp;&nbsp; 邱裕芳误诊误治医疗事故的后续进展，找良医网将持续予以关注。</span></p><p style=\"line-height:200%\"><span style=\"font-size: 19px;line-height:200%\">&nbsp;</span></p>","barId":"1794","topicTypeId":null,"topicThemeId":"1034","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"1199","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"股骨头手术后多久下床","content":"<p>对于70岁的老人换股骨头手术后，几天能下床</p>","barId":"1794","topicTypeId":null,"topicThemeId":"1033","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"4399","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"股骨头坏死治疗方法的选择？","content":"<p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 股骨头坏死的治疗包括非手术治疗和手术治疗，具体选择哪种治疗方式需要根据股骨头坏死的病情严重程度来确定，也就是需要结合股骨头坏死的分期来定。</p><p>　<strong>　1.非手术治疗 <br/></strong></p><p><br/>　　非手术治疗适用于Ⅰ、Ⅱ期病变范围较小者。非手术治疗过程中，要严格定期随访。</p><p>　　<strong>（1）物理方法&nbsp;&nbsp;</strong>&nbsp;①减轻负重：对于单侧病变，患侧应严格避免负重，建议扶拐、用助行器行走。若双髋同时受累，可扶双拐或坐轮椅；②高压氧：通过提高氧分压，改善骨细胞缺氧从而促进股骨头修复；③冲击波：适当能量标准的冲击波治疗股骨头坏死的原理可能是刺激血管再生、诱导骨生长和改变组织结构及骨重建；④超短波：在股骨头缺血早期即进行超短波干预治疗，中等剂量的超短波可使局部血管扩张，血流加速，改善缺血状态，加快局部坏死组织的清除，促进病变组织的修复。</p><p><strong>　&nbsp;&nbsp;（2）药物治疗</strong>&nbsp;&nbsp;包括抗凝（低分子肝素等）、增加成骨（阿仑磷酸钠等）、增加纤溶（川芎嗪等）、中药（健骨生等），这些药物具有一定效果。</p><p>　<strong>　（3）介入疗法</strong>&nbsp;&nbsp;透视下，将多种药物直接、快速注入供给股骨头血运的血管（如旋股内、外侧动脉）内，改善血供，促进坏死骨吸收和新骨形成，创造有利于骨坏死区修复再生的环境。</p><p>　　非手术治疗方法中，除减轻负重延缓股骨头塌陷的效果比较确切外，其他方法的效果均很有限。</p><p>　　<strong>2.手术治疗 <br/></strong></p><p><br/>　　手术治疗适用于Ⅱ期以上患者，但不同分期及严重程度其手术方式有所不同。</p><p>　<strong>　（1）髓心减压术&nbsp;&nbsp;</strong>髓心减压术的原理是通过降低股骨头髓腔内的压力从而恢复股骨头内正常的血运并减轻疼痛。这种方法操作简单，损伤较小，即使手术失败也不会增加其他手术的难度，主要用于治疗ARCOⅠ、Ⅱ期股骨头坏死患者，Ⅲ期患者也可采用这种方法，但效果相对较差。</p><p>　<strong>　（2）不带血管蒂的骨移植</strong>&nbsp;&nbsp;不带血管蒂的骨移植通过去除死骨，应用自体皮质骨和松质骨填充，起到钻孔减压、支撑和骨诱导的作用，主要用于ARCOⅡ、Ⅲ期患者，Ⅳ期效果较差。</p><p>　<strong>　（3）带血管骨瓣（骨膜）移植</strong>&nbsp;&nbsp;此手术适用于各种类型ARCOⅡ～Ⅳ期患者，对于较年轻的晚期患者尤为适宜。缺点是手术复杂、时间长、创伤大、供区并发症较多、血管解剖变异较常见、开窗刮除死骨减弱了股骨头的机械强度、手术后需限制负重6～12个月。大部分研究人员均认为，对严重的ARCOⅡ～Ⅳ期患者，病灶过大以致于使用常规骨移植不能愈合者可选用此类手术。</p><p><strong>　　（4）截骨术</strong>&nbsp;&nbsp;截骨术的目的是将正常骨代替坏死骨成为主要承重部位。这一方法包括经转子旋转截骨、转子间内翻（外翻）截骨，也可结合植骨术，主要适用于ARCOⅡ～Ⅳ期且病变范围较小的患者。</p><p>　　截骨术的技术要求较高，且进一步破坏了股骨头的血运，使坏死区的修复更加困难，如截骨失败，增加了以后髋关节置换术时手术的难度。所以，选择此手术应当慎重。</p><p>　&nbsp;<strong>（5）支撑架植入的股骨头重建术&nbsp;&nbsp;</strong>这是近年来治疗股骨头坏死的一种新技术，其原理是：清除死骨后，用骨水泥或骨替代材料等填充缺损部位，使塌陷的软骨面复位，重建股骨头轮廓。</p><p>　　多孔钽金属为一种新的骨替代材料，具有很好的生物活性和生物相容性，允许骨和软组织快速附着。钽金属棒植入治疗股骨头坏死的近期效果良好，但需长期随访。</p><p><strong>　　（6）髋关节成形（置换）术&nbsp;&nbsp;</strong>股骨头塌陷或继发骨关节炎为关节成形术的手术指征，也就是可以考虑行关节置换手术，包括股骨头表面置换、全髋表面置换和全髋关节置换等。对于ARCO&nbsp;Ⅲ、Ⅳ期股骨头缺血性坏死且髋臼基本完好的患者采用半髋表面置换可延缓全髋关节置换术的手术时间。当病变累及髋臼时应采用全髋关节表面置换或全髋关节置换。</p>","barId":"1794","topicTypeId":null,"topicThemeId":"1032","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"1995","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"股骨头坏死的早期症状是什么","content":"<p>&nbsp;</p>\n<p style=\"text-indent: 2em;\">股骨头坏死的症状和体征多种多样，病痛出现的时间，发作的程度也不尽相同，但都是以病理演变作为基础。而各种临床表现都不是股骨头坏死所特有的，许多髋关节疾患都可以发生，换句话说，难以通过患者的主观症状和临床检查做出股骨头坏死的诊断。例如髋和骶髂关节许多病变可表现为&ldquo;4&rdquo;字试验阳性，（即屈膝并使髋关节屈曲外展外旋，摆成&ldquo;4&rdquo;字形状放在对侧伸直下肢上，一手按压对侧髂嵴上，另一手放在膝内侧手同时下压，引起臀髋痛）因此也不是诊断股骨头坏死特定体征。</p>\n<p style=\"text-indent: 2em;\">&nbsp;</p>\n<p style=\"text-indent: 2em;\">最常见的症状就是疼痛，疼痛的部位是髋关节、大腿近侧，可放射至膝部。疼痛可以因坏死组织-修复的炎症病变或炎症病灶内的高压引起，可表现为持续痛，静息痛。骨软骨塌陷变形导致创伤性关节炎，或有髋关节周围肌肉韧带附着部位慢性损伤性疼痛。髋部活动受限，特别是旋转活动受限，或有痛性和短缩性跛行。</p>\n<p>&nbsp;</p>","barId":"1794","topicTypeId":null,"topicThemeId":"1029","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"3604","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"股骨头坏死的诊断与治疗","content":"<p>\n\t\t\t\t</p><p style=\"text-indent:2em;\"><strong>一、什么是股骨头坏死?</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">股骨头坏死因其主要病理系股骨头血运受阻，遭受破坏而引起的头部骨质缺血，故多称为股骨头缺血性坏死或股骨头无菌性坏死。</p><p style=\"text-indent:2em;\"><br/></p><p style=\"text-indent:2em;\"><strong>二、为什么会得股骨头坏死?</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">股骨头坏死常见的原因有:&nbsp;&nbsp;&nbsp;</p><p style=\"text-indent:2em;\">1.创伤性股骨头坏死。如外力撞击引起股骨颈骨折、髋关节脱位、髋关节扭挫伤等。</p><p style=\"text-indent:2em;\">2.药物性股骨头坏死。长期服用激素类药物，导致了激素在机体内的积蓄而发病。</p><p style=\"text-indent:2em;\">3.酒精性股骨头坏死。由于长期大量的饮酒而造成酒精在体内的蓄积，导致血脂增高和肝功能的损害。血脂的升高，造成了血液黏稠度的增高，血流速度减缓，使血液凝固性改变，因而可使血管堵塞，出血或脂肪栓塞，造成骨坏死。</p><p style=\"text-indent:2em;\"><br/></p><p style=\"text-indent:2em;\"><strong>三、如何诊断股骨头坏死？</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">1.症状&nbsp;</p><p style=\"text-indent:2em;\">（1）疼痛：疼痛可为间歇性或持续性，行走活动后加重，有时为休息痛。疼痛多为针刺样、钝痛或酸痛不适等，常向腹股沟区，大腿内侧，臀后侧和膝内侧放射，并有该区麻木感。&nbsp;</p><p style=\"text-indent:2em;\">（2）关节僵硬与活动受限：患髋关节屈伸不利、下蹲困难、不能久站、行走鸭子步。早期症状为外展、外旋活动受限明显。</p><p style=\"text-indent:2em;\">（3）跛行：为进行性短缩性跛行，由于髋痛及股骨头塌陷，或晚期出现髋关节半脱位所致。早期往往出现间歇性跛行，儿童患者则更为明显。</p><p style=\"text-indent:2em;\">2.影像学检查</p><p style=\"text-indent:2em;\">X光&nbsp;、&nbsp;CT、&nbsp;MRI等影像学检查。</p><p style=\"text-indent:2em;\"><br/></p><p style=\"text-indent:2em;\"><strong>四、股骨头坏死有什么危害?</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">由于股骨头坏死是一个复杂的病理过程，如早期不能得到及时有效的治疗，就会使股骨头塌陷，关节间隙变窄，最后导致骨关节炎，使患者髋关节功能障碍而致残致瘫。患者在遭受生理病痛的同时，还要遭受心理创伤的煎熬，也给家庭、单位和社会增添了沉重的负担。</p><p style=\"text-indent:2em;\"><br/></p><p style=\"text-indent:2em;\"><strong>五、如何预防股骨头坏死?</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">1.小心摔跤，特别在冬季冰雪地行走时要注意防滑摔倒。</p><p style=\"text-indent:2em;\">2.在体育运动之前，要充分做好髋部的准备活动、感觉身体发热、四肢灵活为度。</p><p style=\"text-indent:2em;\">3.髋部受伤后应及时治疗、切不可在病伤未愈情况下,过多行走，以免反复损伤髋关节。</p><p style=\"text-indent:2em;\">4.在治疗某些疾病上，特别是一些疼痛性疾病时尽量不用或少用激素类药物。若相关疾病必须应用激素时，要掌握短期适量的原则，并配合扩血管药、维生素D、钙剂等，切勿不听医嘱自作主张，滥用激素类药物。</p><p style=\"text-indent:2em;\">5.不要养成长期大量饮酒的毛病。</p><p style=\"text-indent:2em;\">6.对股骨颈骨折要立即就诊，通过适当的治疗，防止骨坏死，术后应定期随访，适当口服促进血运的中药和钙剂，预防股骨头缺血性的发生。</p><p style=\"text-indent:2em;\">7.对职业因素如深水潜水员、高空飞行员、高压工作环境中的人员应注意劳动保护及改善工作条件，确已患病者应改变工种并及时就医。</p><p style=\"text-indent:2em;\"><br/></p><p style=\"text-indent:2em;\"><strong>六、得了股骨头坏死怎么办?</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">1.保守治疗</p><p style=\"text-indent:2em;\">保守治疗主要适应于股骨头未变形的早期患者，其方法包括：</p><p style=\"text-indent:2em;\">（1）尽可能减少激素用量；</p><p style=\"text-indent:2em;\">（2）限制负重、卧床加牵引，髋人字石膏固定等；</p><p style=\"text-indent:2em;\">（3）防治骨质疏松：充分补充钙剂和维生素D，使用一些治疗骨质疏松的药物如降钙素或阿仑膦酸钠等；</p><p style=\"text-indent:2em;\">（4）降脂药和抗凝药：有研究报告认为，在使用激素的同时联合用他汀类药物可以预防骨坏死的发生；</p><p style=\"text-indent:2em;\">（5）物理疗法：主要通过热效应或机械应力，改善局部血液循环。物理疗法包括冲击波、超短波、分米波、电刺激等多种治疗方法。</p><p style=\"text-indent:2em;\">（6）介入治疗：介入治疗是将药物直接注入股骨头供血动脉，或插管灌注配合局部坏死区内注射促骨生长剂，以改善局部血供，促进新骨生长，修复坏死股骨头的目的；</p><p style=\"text-indent:2em;\">（7）高压氧治疗：通过提高血氧分压，改善骨细胞缺氧来促使股骨头修复。</p><p style=\"text-indent:2em;\">2.手术治疗</p><p style=\"text-indent:2em;\">手术治疗方法多，是股骨头缺血性坏死治疗的主要方法。</p><p style=\"text-indent:2em;\">（1）髓芯减压术+腓骨移植术：既清除了坏死骨又减轻了骨内压，同时提供了有限的机械支撑，适用于早期，股骨头仍未塌陷的情况；</p><p style=\"text-indent:2em;\">（2）全髋关节置换术：股骨头缺血性坏死的患者，病情发展到晚期，出现髋臼和股骨头严重破坏，关节功能严重障碍，就必须做全髋关节置换术。对有条件的患者建议选用陶瓷界面的髋关节,达到减少假体反应、减低磨损的目的，适用于晚期的患者。</p><p style=\"text-indent:2em;\"><br/></p><p style=\"text-indent:2em;\"><strong>七、髋关节置换术后需要注意什么?</strong></p><p style=\"text-indent:2em;\"><strong><br/></strong></p><p style=\"text-indent:2em;\">髋关节术后如果患肢过度外旋或内收可能发生关节脱位，正确的睡姿是两腿适当分开脚尖向上可防止脱位。术后&nbsp;2&nbsp;周可以拆线出院了，此时您的人工髋关节应该达到可以伸直，屈曲&nbsp;70&nbsp;度，可适当外展，拄助行器可以行走。</p><p style=\"text-indent:2em;\">正确的侧卧位，健侧在下，两腿间夹枕。通常关节置换10周后能够不用拐行走，您可以从事大多数日常活动，可以用坐便器，坐椅子，散步，骑车，跳舞，游泳。您不可以蹲便坑，坐矮凳，做低软的沙发，跪姿，盘腿坐，翘二郎腿。还要注意不要过度弯腰拾物，&nbsp;3月内不要患肢在下侧卧，侧卧时应健肢在下两腿间夹枕头。</p><p><br/></p><p><br/></p>","barId":"1794","topicTypeId":null,"topicThemeId":"1028","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":1},{"id":"2503","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"userId":null,"title":"酒精是如何导致股骨头坏死的？","content":"<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp; &nbsp;</span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">酒精性股骨头坏死是一种很严重的疾病，其主要症状就是疼痛、关节活动受到限制、跛行。那么，酒精是如何导致股骨头坏死呢？</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;&nbsp; </span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">目前虽然关于股骨头坏死的病理机制学说很多，但股骨头缺血是股骨头坏死的基本病理。股骨头处于缺血状态以后，骨细胞与骨组织的正常代谢与功能受到影响而致坏死。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><strong><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">酒精性骨头坏死的病因病理如下：</span></strong></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><strong><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">1.</span></strong><strong><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">脂肪肝和高脂血症</span></strong></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">酒精代谢的结果使脂肪在肝内出现堆积，形成脂肪肝，不断放出脂肪栓子进入血液，脂肪栓子滞留于软骨下血管床内，引起软骨缺血而坏死。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><strong><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">2.</span></strong><strong><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">骨质疏松</span></strong></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;&nbsp; </span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">饮酒可造成维生素</span><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">D</span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">代谢紊乱，甲状旁腺机能减退，骨细胞代谢降低，成骨能力减低，发生骨质疏松，导致局部受力面积减少而产生高应力的成骨反应，骨细胞破坏，软骨下出现微小骨折，引起局部骨内压升高和出血，导致骨坏死。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><strong><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">3.</span></strong><strong><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">局部血管炎</span></strong></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;&nbsp; </span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">大量饮酒刺激前列腺素升高，使局部发生血管炎，在股骨头微血管存在病变的情况下局部形成血栓。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><strong><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">4.</span></strong><strong><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">脂质代谢紊乱</span></strong></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">酒精代谢主要在肝脏进行，并产生乙醛，导致脂质过氧化，过氧化脂质引起细胞膜的重度损伤，局部缺血，加之酒精及其代谢产物的直接细胞毒性作用，使缺血状态下的骨细胞进一步损害，导致不可逆的变性坏死。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 14.0pt; line-height: 200%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">酒精长期积累存在于体内，会导致股骨头坏死，所以我们要开始戒酒限酒，预防骨科疾病。</span></p>\n<p style=\"text-indent: 2em;\">&nbsp;</p>\n<p class=\"MsoNormal\" style=\"line-height: 200%;\"><span lang=\"EN-US\" style=\"font-size: 14.0pt; line-height: 200%;\">&nbsp;</span></p>","barId":"1794","topicTypeId":null,"topicThemeId":"1026","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":0,"score":0,"partCount":0,"replayCount":0,"publishStatus":0,"publishTime":0,"isCream":null,"canReply":0,"shareUrl":null,"foodCouponVal":0,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":0,"metaSearch":null,"rn":2}],"pageObj":{"list":[],"list4Map":null,"pageBegin":0,"pageSize":5,"pageNumber":0,"totalPage":0,"totalRow":0},"loginUser":null,"replies":[],"forumUserFans":null,"herfList":[],"only":"0","topic":{"id":"4531","isDel":0,"createAt":1485239576935,"createBy":"3cc2575ce14111e6a61c00163e04584d","createName":"柠檬茶","updateAt":0,"updateBy":null,"updateName":null,"userId":"3cc2575ce14111e6a61c00163e04584d","title":"长期喝酒抽烟是股骨头健康的大敌","content":"<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp; &nbsp;</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">红网株洲</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">12</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">月</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">28</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">日讯（时刻新闻记者</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">王兴夏</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">通讯员</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">杜方江）从力举三百、威武雄壮，到举步维艰、彻夜难眠，一年多来，</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">63</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">岁的茶陵人段先生的命运一下跌至谷底。他被诊断为双侧股骨头缺血性坏死。株洲市中医伤科医院髋关节科副主任医师雷桂平称，这或与其长期饮酒抽烟有紧密联系。今日，段先生已康复出院。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><strong><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">爱烟酒的&ldquo;大力士&rdquo;股骨头坏死</span></strong></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">熟悉段先生的人都知道他力能扛鼎，肩扛担挑三百斤也不怎么费力，身形高大，强壮矫健，身边的人都夸他身体好。但长期以来，爱烟贪酒，也给他的健康埋下了隐患。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">段先生称自己一天</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">2</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">包烟，一日三餐，顿顿有酒，每天饮白酒量至少在半斤以上。日复一日，时间来到</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">2014</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">年</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">4</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">月，从事体力活的他在劳作时发生轻微扭伤，致使左髋部疼痛，活动感觉有所受限。同年</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">6</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">月，出现无明显诱因的双侧髋部疼痛，活动受限愈加明显，症状有逐渐加重的趋势。因为疼痛，他彻夜难眠，苦不堪言。为此，段先生分别在本地及长沙就医，被诊断为双侧股骨头坏死，行内服、针灸理疗等多种治疗方式，非但效果寥寥，且有加重。今年初，他必须借助双拐才能行走。随后，来到株洲市中医伤科医院就医，确诊为双侧股骨头缺血性坏死，并入院治疗。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">&ldquo;患者的双侧股骨头已经变形、塌陷，关节间隙变窄，必须做关节置换。&rdquo;雷桂平称手术于本月</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">8</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">日进行，&ldquo;术后效果不错，疼痛解除，患者已康复出院。&rdquo;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">长期喝酒抽烟是股骨头健康的大敌</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">&ldquo;从患者的生活习惯，以及从临床看，长期抽烟饮酒很有可能是股骨头坏死的主要原因。&rdquo;雷桂平表示，长期的烟酒熏染，可致股骨头部位的血管挛缩，血供不足，营养难以为继，进而出现坏死，其晚期致残率较高。&ldquo;这有着突出的临床表现。&rdquo;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">且饮酒越多，酒精性股骨头坏死的患病风险也越大。有研究称，引发发病的饮酒时间最长的为</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">20</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">年以上，最短的为</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">5</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">年左右，且酒精量越大，股骨头坏死率越高，酒精浓度越高，坏死率也越高。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">雷桂平介绍，伤科医院髋关节科，一年收治的因股骨头坏死而住院接受手术治疗的患者大概有四五十例。长期过量饮酒是很突出的致病原因，但很多人却浑然不知。有研究显示，酒精性股骨头坏死患者约占总患者人数的</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">30%</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">，多为双侧发病。酒场如战场，很多人频于应酬，饮酒过多，几年内就导致了股骨头坏死，但存在着个体差异。</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">&ldquo;另外，服用激素类药物也可致股骨头坏死，这在非典时有明显表现，因为大剂量的使用激素类药物，有不少非典患者后来就出现了股骨头坏死的症状，像类风湿性关节炎，红斑狼疮及顽固性皮肤过敏等病症，都可能要长期服用激素类药物。&rdquo;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">&ldquo;激素类药物也会影响到股骨头部位的血运。&rdquo;雷桂平建议尽量避免使用激素类药物，能不吃就不吃。同时，引起股骨头坏死的还有先天性的髋关节发育不良，&ldquo;一般女性居多，可出现无明显诱因的髋部疼痛，且会逐渐加重，尤其在负重时更加明显。发病最为集中在</span><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">50</span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">岁左右。稍有症状，建议赶紧检查，及时干预，可延缓病情发展。如减少负重活动，减肥等。&rdquo;</span></p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span lang=\"EN-US\" style=\"font-size: 12.0pt; line-height: 150%;\">&nbsp;&nbsp;&nbsp; </span><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">股骨头坏死，外伤也是因素之一。&ldquo;所以我们建议健康的人，平时就要注意禁烟限酒，保持合适的体重，以及好心情等。&rdquo;雷桂平建议有症状的，就到医院专科正规就医。</span></p>\n<p>&nbsp;</p>\n<p class=\"MsoNormal\" style=\"line-height: 150%;\"><span style=\"font-size: 12.0pt; line-height: 150%; font-family: 宋体; mso-ascii-font-family: Calibri; mso-ascii-theme-font: minor-latin; mso-fareast-font-family: 宋体; mso-fareast-theme-font: minor-fareast; mso-hansi-font-family: Calibri; mso-hansi-theme-font: minor-latin;\">注：股骨头坏死表现：大腿前内侧、膝部及腹股沟、臀部等出现麻木或疼痛，有的人髋关节及其周围关节出现隐痛、钝痛，活动后加重，进一步发展后髋关节活动受限。</span></p>","barId":"1794","topicTypeId":"1","topicThemeId":"1026","readLevel":0,"files":"","clickNoLikeCount":0,"clickLikeCount":0,"clickCount":1603,"score":0,"partCount":0,"replayCount":0,"publishStatus":1,"publishTime":1485239576936,"isCream":0,"canReply":0,"shareUrl":null,"foodCouponVal":1,"emailNotice":0,"permission":0,"zlyShare":0,"status":0,"sort":0,"highlight":0,"highlightEffectTime":0,"digest":0,"digestEffectTime":0,"top":0,"topEffectTime":0,"closed":0,"stamp":0,"icon":0,"bgcolor":null,"fontcolor":null,"favtimes":0,"isAdopt":0,"adoptId":null,"sortDate":1485239576935,"metaSearch":null,"rn":null},"userAllInfo":{"id":null,"isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":null,"password":null,"level":0,"nickName":null,"realName":null,"signName":null,"head":null,"phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":0,"userType":0,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":0,"provinceId":null,"cityId":null,"userLevel":0,"modifyNameCount":0,"forumUser":{"id":"3cc2575ce14111e6a61c00163e04584d","isDel":0,"createAt":1485158098983,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"username":"柠檬茶","password":"888888","level":0,"nickName":"柠檬茶","realName":null,"signName":"柠檬茶，我最爱","head":"http://01luntan.com/ly_img/1485160807561.jpg","phone":null,"mobile":null,"wechat":null,"qq":null,"email":null,"address":null,"identityType":6,"userType":2,"isPhoneBind":0,"status":0,"accountSource":0,"isStrangerMsg":0,"departmentId":null,"departmentName":null,"sex":1,"provinceId":"110000","cityId":"","userLevel":0,"modifyNameCount":1},"forumUserActiveInfo":{"id":"3cc55c11e14111e6a61c00163e04584d","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":1703917542788,"updateBy":"3cc2575ce14111e6a61c00163e04584d","updateName":"柠檬茶","userId":"3cc2575ce14111e6a61c00163e04584d","topicCount":961,"replayCount":26,"favorteCount":0,"beFavorteCount":0,"creamCount":0,"focusCount":0,"fansCount":0,"integralCount":1464,"foodCouponCount":0,"lastLoginTime":0,"lastLoginIp":null,"downloadCount":0,"uploadCount":0},"newPass":null,"focusBar":null,"counter":null,"forumUserIdentificateDto":null},"theme":{"id":"1026","isDel":0,"createAt":0,"createBy":null,"createName":null,"updateAt":0,"updateBy":null,"updateName":null,"topicTypeId":"1","topicTypeName":"资讯","themeName":"病因","barType":"102","schemaName":2,"reward":0},"page":1,"favorties":true,"isSelf":false,"order":"asc"}