双侧全膝关节同期置换术  

Bilateral TKR Simultaneity

作　　者：徐永胜[1] 吕龙[1] 武瑞星[1] 刘江[1] 张剑君[1] 范国强[1] 李华[1] 王文筠[1] 刘剑峰[1] 李临齐[1] 王佩金[1] 常振华[1] 姚丕奇[1] 

机构地区：[1]内蒙古自治区医院骨科,内蒙古呼和浩特010017

出　　处：《内蒙古医学杂志》2006年第4期302-304,共3页Inner Mongolia Medical Journal

摘　　要：目的：探讨在一次手术进行全膝关节置换术（BTKR）与分期进行BTKR之间的差异，对患者的并发症、临床疗效、住院时间及住院费用等进行比较。明确双膝关节同时置换术的可行性及治疗效果。方法：将双膝关节置换的患者分成两组，Ⅰ组为同期BTKR组，共28例患者（56个膝关节）；Ⅱ组为分期BTKR组（手术间隔3～10个月之间），共19例（3S个膝关节），术后随访时间平均为24．3个月。结果：BTKR患者两组的并发症、术后住院时间及随访HSS评分无统计学意义。Ⅰ组住院总时间较Ⅱ组患者平均少21～22d，患者费用减少32．5％。结论：与分期BTKR相比，同时BTKR具有住院时间短、住院费用低、术后康复快等特点。同期BTHR是可行的，病人在一次手术中获得BTKR，不仅节约了医疗费用，而且避免了分次手术的痛苦。但是同期BTKR要求较高，出血量相对较大、麻醉时间相对较长。对于年龄大，术前全身一般情况较差的患者同期BTKR比分期BTKR并发症发生率增高，危险性加大。因此，对于年龄大，一般状况较差的患者以及技术条件还不成熟的医院，应慎重选择同期BTKR。Objective ：To investigate the differences of complication rate, clinical outcome, hospitalized days, overall hospital costs between BTKR simultaneity under a single operation and BTKR by stage. Methods： Patients operated on BTKR were divided into 2 groups： Group Ⅰ 28 cases（56knees）were operated simultaneously; Group Ⅱ 19 cases（38 knees）were operated by two stage procedure（surgery performed between 3 months and 10 months apart. All patients were evaluated after an average follow - up of 24.3 months. Results： Between the two groups operated on BTKA, there were no statistic signification between clinical outcome and postoperative hospitalized days. The mean score of HSS after surgery were similarity between the two groups. Average hospitalized days in Group Ⅰ were less 21 to 22 days than in Group Ⅱ. Overall hospitalized expenses decreased by 48 %. Conclusions：The peculiarity of Group 1 was short hospitalized days, lower overall hospital costs, sooner recovery after operation. BTKR simultaneity is feasible. BTKR simultaneity is finished in one operation. Not only sparing costs but also avoiding pain by 2 - stage procedure. But BTKR simultaneity need higher technique. Complication incidence rate and risk is higher in group Ⅰ than in group Ⅱ Therefore BTKR simultaneity must be cautious in elder patients, patients with lower condition, the hospital where technique and condition were poor.

关 键 词：双侧全膝关节置换术 同期 分期 

分 类 号：R687.49[医药卫生—骨科学]