同期和分期手术在全髋关节置换术中的治疗效果比较  

Comparison of the effects of the simultaneous surgery vs.staged surgery in total hip replacement

作　　者：戴传强 肖尧[2] 李跃辉[1] 梁刚[1] 钟晓[1] DAI Chuanqiang;XIAO Yao;LI Yaohui;LIANG Gang;ZHONG Xiao(Department of Orthopaedics, the First People’s Hospital of Ziyang, Ziyang 641300, China)

机构地区：[1]资阳市第一人民医院骨科,四川资阳641300 [2]四川省医疗卫生技术咨询所<实用妇产科杂志>编辑部,成都610041

出　　处：《骨科》2017年第2期117-120,共4页ORTHOPAEDICS

摘　　要：目的比较同期和分期手术在全髋关节置换术的治疗效果,以期为全髋关节置换术式的选择提供依据。方法回顾性分析资阳市第一人民医院于2009年10月至2015年6月行双侧全髋关节置换术163例病人的临床资料。按照治疗的不同选择分为同期髋关节置换术组(同期组,103例)、分期髋关节置换术组(分期组,60例)。比较两组病人手术时间、出血量、术中输血量、住院费用、住院时间、手术前后Harris评分及术后并发症等情况。结果同期组病人的平均手术时间为(171.5±1.2)min,平均出血量为(1 231.2±3.1)ml,平均术中输血量为(1 056.1±7.5)ml,并发症发生率为14.56%(15/103),手术前Harris评分为(23.3±1.0)分、术后为(87.9±2.5)分;分期组病人的平均手术时间为(191.8±2.3)min,平均出血量为(1 372.3±4.8)ml,平均术中输血量为(978.9±6.5)ml,并发症发生率为23.33%(14/60),手术前Harris评分为(24.8±3.9)分、术后为(84.1±3.6)分。两组病例以上指标比较,差异均无统计学意义(均P>0.05)。但是同期组病人住院费用为(3.9±0.6)万元、住院时间为(15.1±1.3)d,均优于分期组的(5.6±1.3)万元、(28.7±2.5)d,差异均有统计学意义(均P<0.05)。结论对于双侧全髋关节置换术病人,同期手术与分期手术治疗效果无明显差异,但同期手术可以明显降低病人住院费用、住院时间,减轻病人负担。Objective To investigate the clinical effects of the simultaneous surgery vs.staged surgery in patients with total hip replacement.Methods The clinical data of patients undergoing bilateral total hip arthroplasty in our hospital from October2009to June2015were collected.The therapeutic effects of the patients were analyzed retrospectively.According to the choice of different surgical methods,patients were divided into the simultaneous total hip replacement(simultaneous group)and the staged total hip replacement(staging group).The operative time,intraoperative and postoperative bleeding,blood transfusion,hospitalization expenses,hospital stay,Harris score before and after operation and postoperative complications were compared between two groups.Results There was no significant difference in the operative time(t=1.036,P=0.385),total amount of bleeding(t=0.968,P=0.572),blood transfusion(t=1.102,P=0.359)and Harris score(t=1.436,P=0.106;t=1.451,P=0.928)between two groups.The hospitalization expenses(t=3.857,P=0.015)were decreased,and hospital stay(t=3.996,P=0.012)was shortened in simultaneous group as compared with those in staging group.Conclusion There are no significant difference in the curative effects between the simultaneous and staging total hip replacement,but the simultaneous total hip replacement can significantly reduce the cost of hospitalization,and shorten hospital stay.

关 键 词：同期 分期 全髋关节置换术 

分 类 号：R687.4[医药卫生—骨科学]