同期与分期行双侧全髋关节置换术的短期临床结果比较  

Comparison of short-term clinical results between synchronous and staged bilateral total hip ar- throplasty

作　　者：李毓灵[1] 傅峥[1] 张健[1] 

机构地区：[1]重庆医科大学附属第一医院骨科,400016

出　　处：《中华创伤杂志》2013年第7期637-640,共4页Chinese Journal of Trauma

摘　　要：目的比较同期与分期行双侧全髋关节置换术（totalhiparthroplasty，THA）的临床疗效及安全性。方法将2008年1月-2010年1月收治的行双侧THA的患者共58例（116个髋关节）行回顾性分析，随访期限为术后2年：同期行双侧THA29例（同期组），分期行双侧THA29例（分期组）。对比两组患者的手术总时间、总失血量、总输血量、住院时间及费用、术后双侧肢长差异、术前术后功能评分、围术期并发症。结果两组患者随访期限内均未出现切口感染、深静脉血栓、人工关节脱位、假体松动等并发症，仅4例患者出现术后谵妄症状（同期组3例，分期组1例）。两组的总手术时间[同期组为（117．9±23．8）min，分期组为（124．1±18．8）min]、总失血量[同期组为338．1ml（180～720m1），分期组为303．9ml（200～600m1）]、总输血量[同期组为227．6ml（0—800m1），分期组为189．7ml（0～400m1）]、术后功能恢复情况差异无统计学意义，而住院费用[同期组为9．5万元（7．0～11．3万元），分期组为10．5万元（8．8—11．0万元）]、住院时间[同期组为（12．1±3．2）d，分期组为（20．1±3．5）d]、术后肢长[同期组为（0．11±0．22）cm，分期组为（0．42±0．44）cm]差异有统计学意义（P〈0．05或P〈0．01）。结论在患者身体条件允许、围术期管理得当、医师手术技术成熟的情况下，同期行双侧THA是安全可行的，且在患者住院费用、住院时间、术后肢长差异方面与分期行双侧THA相比有一定的优势。Objective To compare the clinical outcomes and safety of synchronous vs staged bi- lateral total hip arthroplasty （THA）. Methods Fifty-eight cases （116 hip joints） undergone bilateral THA from January 2008 to January 2010 were reviewed retrospectively. Follow-up period was postopera- tive 2 years, including synchronous bilateral THA in 29 cases （synchronous group） and staged bilateral THA in 29 cases （staged group）. The two patient groups were compared in aspects of total operation time, total amount of blood loss, total amount of blood transfusion, duration and cost of hospitalization, postoperative discrepancy in bilateral leg length, preoperative and postoperative function score and periop- erative complications. Results During the follow-up, no complications of incision infection, deep vein thrombosis and prothesis dislocation or loosening were noted. And postoperative delirium symptoms oc- curred only in four eases （three in synchronous group and one in staged group）. There were no statistical differences between synchronous group and staged group in aspects of total operating time [ （ 117.9 ± 23.8） minutes vs （124. 1 ± 18.8） minutes], total amount of blood loss [338.1 ml （180-720 ml） vs 303.9 ml （200-600 ml） ], total amount of blood transfusion [227.6 ml （0-800 ml） vs 189.7 ml （0- 400 ml） ], postoperative function score. However, differences of the following data were considered statisti- cal significance between synchronous group and staged group ： expense of hospitalization [ 9.5 ten thousand ynan （7.0-11.3 ten thousand yuan） vs 10.5 ten thousand yuan （8.8-11.0 ten thousand yuan）], length of hospitalization [ （12.1 ± 3.2 ）days vs （20.1 ± 3.5 ） days ], postoperative discrepancy in bilateral leg length [ （0.11 ±0.22） cm vs （0.42 ±0.44） cm]. Conclusions Synchronous bilateral THA is safe andfeasible as far as the patients＇ physical condition is allowed, perioperative management is rational and physicians have mature surgical techniq

关 键 词：髋损伤 关节成形术 置换 髋 功能恢复 腿长不等 

分 类 号：R687.4[医药卫生—骨科学]