同期双侧全膝关节置换术应用于高龄双膝关节骨关节炎患者的效果分析  

Analysis of effects of simultaneous bilateral total knee replacement on elderly patients with osteoarthritis of both knees

作　　者：陈宗超 尹锐峰[1] 张长城[1] 李卫华 Chen Zong-chao;Yin Rui-feng;Zhang Chang-cheng;Li Wei-hua(Department of Orthopedics,Nanyang Central Hospital,Nanyang 473000,Henan,China;Department of Orthopedics,Huaihe Hospital,Henan University,Kaifeng 475000,Henan,China)

机构地区：[1]南阳市中心医院骨科,河南南阳473000 [2]河南大学淮河医院骨科,河南开封475000

出　　处：《四川生理科学杂志》2023年第10期1789-1791,1777,共4页Sichuan Journal of Physiological Sciences

摘　　要：目的:探讨同期双侧全膝关节置换术应用于高龄双膝关节骨关节炎患者的临床价值及对患者膝关节功能、关节液转化生长因子β1(Transforming growth factorβ1,TGF-β1)及肿瘤坏死因子α(Tumor necrosis factorα,TNF-α)水平的影响。方法:选取我科2020年5月至2021年12月期间121例高龄双膝关节骨关节炎患者为本次研究对象,依据手术方式,将患者分为对照组和观察组。对照组患者60例给予单侧分期全膝关节置换术(Unilateral stage total knee replacement,UTKA)治疗,观察组61例给予同期双侧全膝关节置换术(Simultaneous bilateral total knee replacement,SBTKA)治疗。对比两组各项手术相关指标;术后2m,比较两组患者的膝关节功能水平、膝关节液TGF-β1、TNF-α水平。结果:观察组患者手术时间、术中出血量、术后引流量、术后住院时间均低于对照组,住院时间低于对照组(P<0.05);手术2m后,观察组患者膝关节疼痛、僵硬、生理功能等评分均低于对照组,观察组患者TGF-β1水平高于对照组,TNF-α水平低于对照组(P<0.05)。结论:与UTKA相比,SBTKA治疗双膝关节骨关节炎的恢复速度更快,能够有效提高患者预后膝关节功能,改善其关节液炎性因子表达水平。Objective:To investigate the clinical value of simultaneous bilateral total knee replacement(SBTKA)in elderly patients with osteoarthritis of both knees and the effects on knee function,joint fluid transforming growth factorβ1(TGF-β1)and tumor necrosis factorα(TNF-α)levels.Methods:A total of 121 elderly patients with osteoarthritis of both knees from May 2020 to December 2021 in our department were selected as the objects of this study.According to the surgical methods,the patients were divided into control group and observation group.In control group,60 patients were treated with Unilateral stage total knee replacement(UTKA).SBTKA was performed in 61 patients in the observation group.The indexes related to surgery were compared between the two groups.Two months after surgery,the levels of knee function,knee fluid TGF-β1,TNF-αwere compared between the two groups.Results:The operation time,intraoperative blood loss,postoperative drainage volume and postoperative hospital stay in observation group were lower than those in control group,and the hospital stay in observation group was lower than that in control group(P<0.05).Two months after surgery,knee pain,stiffness,physiological function scores in observation group were lower than those in control group,TGF-β1 level in observation group was higher than that in control group,TNF-αlevel in observation group was lower than that in control group(P<0.05).Conclusions:Compared with UTKA,SBTKA has a faster recovery rate in the treatment of osteoarthritis of both knees,and can effectively improve the prognostic knee function of patients and the expression levels of inflammatory factors in joint fluid.

关 键 词：同期双侧全膝关节置换术 双膝关节骨关节炎 膝关节功能 关节液炎性因子 

分 类 号：R687.4[医药卫生—骨科学]