加速康复外科理念在人类免疫缺陷病毒感染合并股骨头坏死患者行全髋关节置换中的临床疗效分析  

Clinical efficacy of ERAS in patients with human immunodeficiency virus infection and femoral head necrosis undergoing total hip arthroplasty

作　　者：伊力亚尔·巴吐尔 马良 宋玉霞 地里下提·阿不力孜 唐伟 古甫丁 Yiliyaer Batuer;MA Liang;SONG Yu-xia;Dilixiati Abulizi;TANG Wei;GU Fu-ding(Department of Orthopedics,Infectious Disease Hospital of Xinjiang Ugur Autonomous Region,Urumqi,Xinjiang,830049,China)

机构地区：[1]新疆维吾尔自治区传染病医院骨科,乌鲁木齐830049

出　　处：《中国骨与关节杂志》2025年第3期254-259,共6页Chinese Journal of Bone and Joint

基　　金：新疆维吾尔自治区医药卫生天山英才项目(TSYC202301A060)。

摘　　要：目的探讨加速康复外科(enhanced recovery after surgery,ERAS)理念在人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染合并股骨头坏死患者行全髋关节置换(total hip arthroplasty,THA)治疗中的应用价值。方法回顾分析2020年1月至2023年6月我院骨科收治的41例因股骨头坏死行THA治疗的HIV感染患者的临床资料,其中围术期采用常规处理方式为对照组(20例),围术期应用ERAS理念为研究组(21例)。比较两组手术时间、术中出血量、住院时间、术后首次下床活动时间,术前及术后24 h的红细胞沉降率、C-反应蛋白、降钙素原、白细胞等指标,术后视觉模拟评分(visual analogue scale,VAS)与术后髋关节功能Harris评分等。结果两组术中出血量比较,研究组(97.14±9.56)ml,对照组(150.50±15.72)ml,差异有统计学意义(P<0.001);两组住院时间比较,研究组9(8,10)天,对照组13(14,15)天,差异有统计学意义(P<0.001);两组术后首次下床活动时间比较,研究组术后1天首次下床活动,对照组术后4天首次下床活动,差异有统计学意义(P<0.001)。两组VAS评分在术后12 h比较,研究组3.52±0.51,对照组4.50±0.51,差异有统计学意义(P<0.001);术后24 h比较,研究组2.57±0.51,对照组3.50±0.51,差异有统计学意义(P<0.001);术后72 h比较,研究组1.57±0.50,对照组2.50±0.51,差异有统计学意义(P<0.001)。两组术后髋关节功能Harris评分在术后3天比较,研究组52.90±2.14,对照组42.95±1.93,差异有统计学意义(P<0.001);术后7天比较,研究组62.62±1.53,对照组52.95±1.54,差异有统计学意义(P<0.001)。两组术前及术后24 h红细胞沉降率、C-反应蛋白、降钙素原、白细胞等指标差异无统计学意义(P>0.05)。结论ERAS理念应用在HIV感染合并股骨头坏死患者行THA治疗中能够缩短住院时间,降低医疗成本,减轻术后疼痛,并且不会增加术后炎症反应以及并发症风险。Objective To explore the application value of enhanced recovery after surgery(ERAS)in total hip arthroplasty(THA)for patients with human immunodeficiency virus infection and femoral head necrosis.Methods A retrospective analysis was conducted on the clinical data of 41 patients with HIV infection who underwent THA for osteonecrosis of the femoral head in our hospital from January 2020 to June 2023.The patients were divided into the control group(20 cases)and the study group(21 cases)according to the perioperative ERAS concept.The operation time,intraoperative blood loss,hospital stay,the first ambulation time after operation,erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT),white blood cell(WBC)and other indicators before and 24 hours after operation,postoperative visual analogue scale(VAS)and postoperative Harris hip function score were compared between the two groups.Results The intraoperative blood loss was(97.14±9.56)mlin the study group and(150.50±15.72)ml in the control group,and the differences were statistically significant(P<0.001).The length of hospital stay was 9(8,10)days in the study group and 13(14,15)days in the control group,and the differences were statistically significant(P<0.001).The first ambulation time of the study group was 1 day after operation,and that of the control group was 4 days after operation,and the differences were statistically significant(P<0.001).The VAS score of the two groups at 12 hours after operation was(3.52±0.51)in the study group and(4.50±0.51)in the control group,and the differences were statistically significant(P<0.001).24 hours after operation,the study group was(2.57±0.51),and the control group was(3.50±0.51),and the differences were statistically significant(P<0.001).72 h after operation,the study group was(1.57±0.50),the control group was(2.50±0.51),and the differences were statistically significant(P<0.001);The Harris score of the two groups at 3 days after operation was(52.90±2.14)in the study group and(42.95±1.93)in the

关 键 词：关节成形术 置换 髋 术后加速康复 HIV感染 股骨头坏死 

分 类 号：R687.4[医药卫生—骨科学]