甲型血友病性关节炎患者多关节置换术的安全性评估及临床效果观察  

The safety and clinical outcome of multi-joint arthroplasty for hemophilic arthropathy

作　　者：仇汪宝 史保庆 王汉邦 梁伟 QIU Wang-bao;SHI Bao-qing;WANG Han-bang;LIANG Wei(Department of Orthopaedics,Fuyang Hospital of Anhui Medical University,Fuyang,Anhui,236000,China)

机构地区：[1]安徽医科大学附属阜阳医院,阜阳236000

出　　处：《中国骨与关节杂志》2023年第10期728-731,共4页Chinese Journal of Bone and Joint

摘　　要：目的报告3例行多关节置换术的A型血友病性关节炎患者。方法2017年7月至2018年10月,我院经治3例甲型血友病性关节炎行多关节置换术患者。对手术前后血红蛋白含量的测定、KSS评分、Harris评分及术后并发症等方面进行数据统计以及进行相关影像学比较。结果1例行双膝关节置换术,2例行双膝关节置换术+单侧全髋关节置换术。患者血红蛋白含量术后1周内趋于持续降低趋势,术后1周开始逐渐恢复;KSS评分由术前(28.12±3.54)分提高至末次随访(73.5±5.54)分,Harris评分由术前(35.0±2.83)分提高至末次随访(84.0±1.41)分;1例单侧膝关节术后出现关节腔出血,未出现感染、血肿、假体松动等并发症。结论甲型血友病性关节炎患者在进行有效凝血因子替代治疗控制出血后行多关节置换术具有可靠的安全性及良好的临床效果。Objective To identify safety and clinical outcomes of multi-joint arthroplasty for hemophilic arthropathy(HA).Methods A retrospective analysis of 3 patients who underwent multi-joint arthroplasty for hemophilic arthropathy between July 2017 and October 2018 was conducted.Hemoglobin,KSS score,Harris score and complication pre-operation and post-operation were collected.Results One patient was performed bilateral total knee arthroplasty(TKA),and two patients were performed bilateral TKA and unilateral total hip arthroplasty(THA).The hemoglobin was decreasing one week post-operation,and began to recover gradually one week later.The average KSS score and Harris score increased from(28.12±3.54),(35.0±2.83),respectively pre-operation to(73.5±5.54),(84.0±1.41),respectively at the last follow-up.There were no complications such as infection,hematoma and prosthesis loosening except for one case with intra-articular hemorrhage after unilateral knee surgery.Conclusions The outcomes of multi-joint arthroplasty for hemophilic arthropathy are satisfactory and safe.

关 键 词：血友病A 关节炎 关节成形术 置换 手术后并发症 膝关节 髋关节 

分 类 号：R684.3[医药卫生—骨科学]