THA治疗HIV感染者ANFH的围手术期处理  

Perioperative Treatment of ANFH in HIV Infected Patients with THA

作　　者：黄杰平 李彪[2] 张建洪 张晓露 寸新华 HUANG Jie-ping;LI Biao;ZHANG Jian-hong;ZHANG Xiao-lu;CUN Xin-hua(Dept.of Orthopaedics,Ganmei Hospital Affiliated to Kunming Medical University,Kunming Yunnan 650011;Dept.of Orthopaedics,The 1st Affiliated Hospital of Kunming Medical University,Kunming Yunnan 650032;Dept.of Orthopaedics,Yunnan Infectious Diseases Hospital,Kunming Yunnan 650301;Dept.of Orthopaedics,Kunming Infectious Diseases Hospital,Kunming Yunnan 650041,China)

机构地区：[1]昆明医科大学第一附属医院,昆明医科大学附属甘美医院骨科,云南昆明650011 [2]昆明医科大学第一附属医院骨科,云南昆明650032 [3]云南省传染病医院骨科,云南昆明650301 [4]昆明市传染病医院骨科,云南昆明650041

出　　处：《昆明医科大学学报》2020年第10期167-172,共6页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2018FE001-283)。

摘　　要：目的观察围手术期处理对应用全髋关节置换治疗人类免疫缺陷病毒HIV感染合并股骨头缺血坏死者,手术并发症的影响。探讨与普通患者同质化的围手术期处理方式。方法回顾性分析2014年2月至2019年12月,37例(41髋)HIV阳性THA治疗患者(HIV感染组),同期42例(45髋)HIV阴性THA治疗患者(对照组)。HIV感染组规范手术期处理并使用免疫调节药物、高效抗逆转录病毒(HAART)治疗,加强职业防护。观察两组并发症的影响。使用方差齐性检验和主体间效应比较:所有P>0.05,方差齐,适合方差分析。结果均顺利完成手术,两组均无感染、假体松动、死亡病例。结论 HIV阳性合并ANFH患者,通过规范手术流程、合理防控感染、营养支持、功能锻炼、抗骨质疏松可以减少并发症发生。Objective To observe the effect of perioperative management on the complications of total hip arthroplasty(THA) in the treatment of HIV infected patients with avascular necrosis of the femoral head so as to explore the perioperative management of homogenization with common patients. Methods From February 2014 to December 2019, 37 patients(41 hips) with HIV positive tha(HIV infection group) and 42 patients(45hips) with HIV negative tha(control group)were analyzed retrospectively. In the HIV infected group, the operation period was standardized and immunomodulatory drugs and HAART were used to strengthen the occupational protection.The effect of perioperative management on the complications of the two groups was observed by using the test of homogeneity of variance and the comparison of effect among subjects: all P>0.05, the variance was homogeneous, which was suitable for the analysis of variance. Results The operation was completed successfully, and there were no cases of infection,loosening of prosthesis and death in the two groups. Conclusion In HIV positive patients with ANFH,the complications can be reduced by standardizing the operation procedure, reasonably preventing and controlling infection, nutritional support, functional exercise and anti osteoporosis.All patients in this group have achieved good clinical effect.

关 键 词：HIV 人工全髋关节置换术 股骨头缺血坏死 生物性髋关节假体 围手术期 

分 类 号：R512.91[医药卫生—内科学]