同期双侧全膝关节置换安全性与有效性的回顾性对照分析  

Retrospective comparative analysis of the safety and effectiveness of bilateral total knee arthro-plasty

作　　者：戴金良[1] 马健[1] 王洪彬[1] 康立新[1] 

机构地区：[1]山东省滕州市中心人民医院关节外科,277500

出　　处：《中国实用医刊》2014年第11期1-4,共4页Chinese Journal of Practical Medicine

摘　　要：目的：比较同期与分期进行双侧全膝关节置换术（ BTKA）安全性与临床效果之间的差异。方法回顾性分析2010年1月至2013年3月随访资料完整的BTKA患者45例，依据是否同期行双侧全膝关节置换术将其分为 A、B两组，A组为同期置换组，B组为分期置换组（手术间隔1～6个月）。比较两组患者的一般资料、术前合并症、术后早期并发症与膝关节功能恢复情况。结果两组患者的年龄、体质量指数比较差异均无统计学意义。分期手术组的患者合并一种或者几种内科合并症的比例明显高于同期手术组。同期置换组术后早期并发症发生率高于分期置换组，术后早期并发症多为心血管并发症、血栓形成、发热及精神方面的并发症。两组患者均无关节周围感染的发生，至随访时无患者死亡。两组患者经过6个月的随访，两组膝关节功能用HSS评分比较差异无统计学意义（P〉0.05）。结论同期BTKA能有效缩短住院和下肢功能康复的时间，但术后早期并发症发生率增高，危险性加大。术前详细评估患者的全身状况，在合理选择患者并进行完善的术前准备下，同期与分期BTKA同样安全可靠且疗效满意。Objective To compare the differences of safety and clinical efficacy between simul-taneous bilateral total knee arthroplasty（ BTKA）and staged bilateral total knee arthroplasty. Methods The clinical data of 45 patients with BTKA,from Jan 2010 to Mar 2013 were retrospectively analyzed. They were divided into group A and group B,the patients in group A were given bilateral total knee ar-throplasty simultaneously,and the patients in group B were given bilateral total knee arthroplasty at different time（ interval time of surgery was 1 to 6 months）. The general information,preoperative complications,early postoperative complications and knee function recovery indicators of the two groups were compared. Results There were no significant differences in the sex ratio,age and body mass index between the two groups. The incidence of complications in group B was higher than that in group A. The incidence of early postoperative complication in group A was higher than that in group B. The early postoperative complications including cardiovascular complications,thrombosis,fever and psychiatric disorder. The infection around joint didn’t appear in either groups. And no patient died until the end of the follow-up. After follow-up of 6 months,there was no significant difference in HSS score of knee joint function between the two groups（ P〉0 . 05 ）. Conclusions Simultaneous BTKA can significantly shorten the hospitalization time and recovery time of lower limb function,but has higher incidence of early postoperative complication and big risk. The detailed body condition of patients need to be evaluated before operation. If the patients are selected reasonably and the preoperative preparation is perfect,simultaneous BTKA and staged BTKA has the same safety,reliability and satisfactory effect.

关 键 词：全膝关节置换 同期 分期 骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]