高风险患者膝关节置换不同手术方案的回顾性对照分析  

Retrospective comparative analysis of different surgical methods for high risk patients with bilateral total knee arthroplasty

作　　者：马健[1] 戴金良[1] 康立新[1] 

机构地区：[1]滕州市中心人民医院关节外科,滕州277500

出　　处：《中国矫形外科杂志》2015年第5期422-425,共4页Orthopedic Journal of China

摘　　要：[目的]探讨高风险患者全膝关节置换术（bilateral total knee arthroplasty,BTKA）不同手术方案之间的差异。[方法]回顾性分析2009年1月～2012年6月随访资料完整的TKA患者39例,依据是否行双侧全膝关节置换术分为A、B两组,A组为双膝置换组,B组为单膝置换组。通过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等方面比较组间差异。[结果]两组患者的年龄、体质指数、术前合并症差异无统计学意义。双膝置换组术后早期并发症发生率高于单膝置换组,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。两组病人经过12个月的随访,膝关节功能用HSS评分比较P〉0.05,差异无统计学意义。[结论]同期BTKA术后早期并发症发生率增高,危险性加大,对于ASA分级三级以上的患者应尽量避免行同期双侧人工全膝关节置换术。[ Objective] To research the differences between the patients with different surgical methods for bilateral total knee arthroplasty. [ Methods] The data of 45 patients of knee joint disease with the treatment of total knee arthroplasty from 2010. 1 to 2012. 6 were analyzed retrospectively. And we had the complete follow - up data of them. They were divided into groups A, B, group A for the patients with bilateral total knee arthroplasty in the same time, group B for the patients with bilat- eral total knee arthroplasty in the different time （ interval time of surgery was 1 to 6 months） . The general information, preoper- ative comorbidities, early postoperative complications, bilateral surgery total drainage volume, the total volume of blood transfu- sion and knee function recovery indicators of the patients of group A were compared with the ones of group B to research the differences between them. [ Results ] There were no statistically significance between two groups in age and body mass in- dex. The proportion of the patients in group B with one or several medical comorbidities was higher than the proportion of the pa- tients in group A before operation. The appeared rates of early postoperative complication in group with simultaneous BTKA was higher than in group with staged BTKA. The most appeared complication was cardiovascular complications, thrombosis and spir- itual aspects complications. There was statistical significante difference between the group with simultaneous BTKA and the group with staged BTKA in total lead flow, total amount of blood transfusion （ P 〈 0.05 ） . After follow - up for twelve months, there was no statistically significant difference in HSS score of knee joint function between two groups （ P 〉 0.05 ） . [ Conclusion] It is appeared the shorter hospitalization time and recovery time in group with simultaneous BTKA. But early postoperative compli- cation rate is higher and the risk increased in group with simultaneous BTKA. The detailed body condition of patient need

关 键 词：全膝关节置换 同期 骨关节炎 

分 类 号：R687.4[医药卫生—骨科学]