高风险患者膝关节置换不同手术方案的回顾性对照分析Retrospective comparative analysis of different surgical methods for high risk patients with bilateral total knee arthroplasty
马健;戴金良;康立新;
摘要(Abstract):
[目的]探讨高风险患者全膝关节置换术(bilateral total knee arthroplasty,BTKA)不同手术方案之间的差异。[方法]回顾性分析2009年1月~2012年6月随访资料完整的TKA患者39例,依据是否行双侧全膝关节置换术分为A、B两组,A组为双膝置换组,B组为单膝置换组。通过两组患者的一般资料、术前合并症、术后早期并发症与膝关节功能恢复情况等方面比较组间差异。[结果]两组患者的年龄、体质指数、术前合并症差异无统计学意义。双膝置换组术后早期并发症发生率高于单膝置换组,术后早期并发症多为心血管并发症、血栓形成、发热及精神方面的并发症。两组病人经过12个月的随访,膝关节功能用HSS评分比较P>0.05,差异无统计学意义。[结论]同期BTKA术后早期并发症发生率增高,危险性加大,对于ASA分级三级以上的患者应尽量避免行同期双侧人工全膝关节置换术。
关键词(KeyWords): 全膝关节置换;同期;骨关节炎
基金项目(Foundation):
作者(Author): 马健;戴金良;康立新;
Email:
DOI:
参考文献(References):
- [1]Hootman J,Helmick CG.Projections of US prevalence of arthritis and associated activity limitations[J].Arthritis Rheum,2006,1:226-229.
- [2]Leonard L,Williamson DM,Ivory JP,et al.An evaluation of the safety and efficacy of simultaneous bilateral total knee arthroplasty[J].J Arthroplasty,2003,8:972-978.
- [3]Yoon HS,Han CD,Yang IH.Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications[OL].J Arthroplasty,2010,2:179-185.
- [4]郇松玮,姚平,刘宁,等.膝关节置换术后不同镇痛方案的疗效评价[J].中国矫形外科杂志,2014,7:601-606.
- [5]巩建宝,孙水,张伟,等.初次全膝关节置换术后引流管夹闭时间选择与隐性失血量的相关性研究[J].中国矫形外科杂志,2014,7:589-593.
- [6]中华医学会骨科学分会.中国骨科大手术静脉血栓栓塞症预防指南[J].中华关节外科杂志(电子版),2009,3:380-383.
- [7]Mc Nally MA,Mollam RAB.Venous thrombolism and orthopedic surgery[J].J Bone Joint Surg Br,1993,4:517-519.
- [8]Wells PS,Anderson DR,Hominanis J,et al.Value of assessment of pretest probability of deep vein thrombosis in clinical management[J].Lancet,1997,12:20-27.
- [9]Blom AW,Brown J,Taylor AH,et al.Infection after total knee arthroplasty[J].J Bone Joint Surg Br,2004,86:688-691.
- [10]陈德胜,李亚平,吕金捍,等.双侧人工全膝关节同期置换预存自体输血28例[J].临床医学,2009,9:1769-1770.
- [11]Lane GJ,Hozack WJ,Shah S,et al.Simultaneous bilateral versus unilateral total knee arthroplasty:outcomes analysis[J].Clin Orthop,1997,345:106-112.
- [12]Yoon HS,Han CD,Yang IH.Comparison of simultaneous bilateral and staged bilateral total knee arthroplasty in terms of perioperative complications[J].J Arthroplasty,2010,2:179-185.
- [13]Kim YH.Incidence of fat embolism syndrome after cemented or cement less bilateral simultaneous and unilateral total knee arthroplasty[J].J Arthroplasty,2006,6:730-739.