| 足夏克氏关节病的诊疗研究进展 |
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投稿时间：2018-10-18
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| 作者 | Author | 单位 | Address | E-Mail |
| 刘国梁 |
LIU Guo-liang |
南京总医院汤山分院骨科, 江苏 南京 211131 |
Department of Orthopaedics, Tangshan Branch of Nanjing General Hospital, Nanjing 211131, Jiangsu, China |
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| 杨彬奎 |
YANG Bin-kui |
南京总医院汤山分院骨科, 江苏 南京 211131 |
Department of Orthopaedics, Tangshan Branch of Nanjing General Hospital, Nanjing 211131, Jiangsu, China |
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| 董宏然 |
DONG Hong-ran |
南京总医院汤山分院骨科, 江苏 南京 211131 |
Department of Orthopaedics, Tangshan Branch of Nanjing General Hospital, Nanjing 211131, Jiangsu, China |
1405dhr@sohu.com |
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| 期刊信息：《中国骨伤》2019年，第32卷，第12期，第1168-1172页 |
| DOI：10.3969/j.issn.1003-0034.2019.12.021 |
| 基金项目: |
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| 中文摘要:足夏克氏关节病是临床罕见病，其发病机制包括神经创伤理论、神经血管理论、综合理论、炎症因子理论等。该疾病以足踝进行性关节及骨质破坏为显著特征，常规X线片检查对该病早期诊断不敏感，CT及MRI的表现具有特征性，可以对疾病的骨质及软组织病变做出全面的评价，结合足踝部肿痛、皮肤温度升高等临床表现不难做出诊断。夏克氏足分类方法较多，包括解剖学、影像学和临床分型等，目前常用的改良Eichenholtz分期对于疾病的评估更全面，对治疗更具指导意义。根据疾病的分期，治疗上主要包括不负重支具保护、药物及手术治疗等，早期诊断、支具保护，可以保护关节，延缓畸形发展；药物治疗的疗效目前尚缺乏长期明确的结论；对于晚期患者，必须积极采取手术治疗，以获得一个稳定有功能的足踝关节，降低截肢率。 |
| 【关键词】足关节 治疗 综述 |
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| Diagnosis and treatment of Charcot's osteoarthropathy |
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| ABSTRACT Charcot foot is a rare disease in clinic,its pathogenesis includes neurotrauma theory,neurovascular theory,comprehensive theory,and inflammatory factor theory. The disease is characterized by progressive joint and bone destruction of foot and ankle joint. Conventional X-ray examination is not sensitive to the early diagnosis of disease,the manifestation of CT and MRI of disease is characteristic and could be used to make a comprehensive evaluation of bone and soft tissue lesions of disease. It is not difficult to make a diagnosis based on characteristic findings of CT and MRI and clinical manifestations such as swelling,pain and skin temperature rising of foot and ankle. Charcot foot has multiple classification methods including anatomy,imaging and clinical classification. Improved Eichenholtz staging classification is most commonly used currently which could make a more comprehensive assessment of disease and guide treatment better. According to the stage of disease,treatment could be carried out including non-weight bearing and brace protection,drugs therapy and surgical treatment,etc. Early diagnosis,brace protection,could protect joint and delaying progression of deformity. There is no clear long-term and generally accepted conclusion about the efficacy of drug therapy. For advanced patients,surgical treatment must be actively performed to preserve a stable and functional ankle joint and reduce amputation rate. |
| KEY WORDS Foot joints Therapy Review |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘国梁,杨彬奎,董宏然.足夏克氏关节病的诊疗研究进展[J].中国骨伤,2019,32(12):1168~1172 |
| 英文格式: | LIU Guo-liang,YANG Bin-kui,DONG Hong-ran.Diagnosis and treatment of Charcot's osteoarthropathy[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(12):1168~1172 |
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