肥胖患者全膝关节置换术的临床疗效观察  

Observation on clinical outcomes after total knee arthroplasty in obese patients

作　　者：秦超西 刘敏[2] 王小铁[2] 

机构地区：[1]山西医科大学第一临床医学院骨科,太原030001 [2]山西医科大学附属晋煤集团总医院骨科

出　　处：《山西医科大学学报》2014年第11期1096-1099,共4页Journal of Shanxi Medical University

摘　　要：目的比较肥胖、超重和体重正常患者全膝关节置换术后的短期功能结果及术后并发症的差异,评价肥胖对全膝关节置换术临床疗效的影响。方法按照BMI将152例接受全膝关节置换术的患者分为3组。其中体重正常组(BMI 18.5-23.9kg/m2)52例,超重组(BMI 24.0-27.9 kg/m2)50例,肥胖组(BMI≥28 kg/m2)50例。记录患者术前的年龄、性别、合并症及术后并发症等情况,进行2年的随访。疗效评估包括美国膝关节协会评分(KSS)、健康调查简表(SF-36)、疼痛视觉模拟评分(VAS)以及住院时间等。结果无论是超重组、肥胖组还是体重正常组,患者全膝关节置换术后的美国膝关节协会评分(KSS)、健康调查简表(SF-36)和疼痛视觉模拟评分(VAS)较术前均有显著改善(P<0.05),且三组之间的住院时间没有显著性差异。与超重组和体重正常组的患者相比,肥胖患者的并发症发生率显著升高(P<0.001)。结论全膝关节置换术在超重和肥胖患者中也可以取得令人满意的短期功能改善,但应重视肥胖患者全膝关节置换术后潜在的围手术期并发症风险。Objective To compare the clinical outcomes and complications after total knee arthroplasty（TKA）among normal weight patients,overweight patients and obese patients.Methods A total of 152 obese patients undergoing TKA were stratified by BMI（18.5-23.9 kg/m^2,normal group,n =52;24.0-27.9 kg/m^2,overweight group,n =50; ≥28 kg/m^2,obese group,n =50）.Preoperative demographics,perioperative and postoperative complications were recorded.They were followed up for two years and the outcomes were assessed using American knee society score,short form-36,visual analog scale pain scores and the length of hospital stay.Results The American knee society score,short form-36 and visual analog scale pain score were significantly improved in all groups （P 〈 0.05）.Moreover,there was no difference in the hospitalized stay among the three groups.The obese patients had a higher incidence of complications than normal weight patients and overweight patients（P 〈0.001）.Conclusion Total knee arthroplasty in overweight and obese patients can be successful in short term follow-up,but the potential perioperative complications in obese patients requires close attention.

关 键 词：肥胖 全膝关节置换 临床疗效 并发症 

分 类 号：R687.4[医药卫生—骨科学]