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同一住院周期一期与分期双侧全膝关节置换疗效比较

王炜 翁习生 林进 金今 钱文伟 邱贵兴

王炜, 翁习生, 林进, 金今, 钱文伟, 邱贵兴. 同一住院周期一期与分期双侧全膝关节置换疗效比较[J]. 协和医学杂志, 2011, 2(1): 56-60. doi: 10.3969/j.issn.1674-9081.2011.01.012
引用本文: 王炜, 翁习生, 林进, 金今, 钱文伟, 邱贵兴. 同一住院周期一期与分期双侧全膝关节置换疗效比较[J]. 协和医学杂志, 2011, 2(1): 56-60. doi: 10.3969/j.issn.1674-9081.2011.01.012
Wei WANG, Xi-sheng WENG, Jin LIN, Jin JIN, Wen-wei QIAN, Gui-xing QIU. Effectiveness and Safety of Simultaneous or Staggered Bilateral Total Knee Arthroplasty in One Hospitalization[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 56-60. doi: 10.3969/j.issn.1674-9081.2011.01.012
Citation: Wei WANG, Xi-sheng WENG, Jin LIN, Jin JIN, Wen-wei QIAN, Gui-xing QIU. Effectiveness and Safety of Simultaneous or Staggered Bilateral Total Knee Arthroplasty in One Hospitalization[J]. Medical Journal of Peking Union Medical College Hospital, 2011, 2(1): 56-60. doi: 10.3969/j.issn.1674-9081.2011.01.012

同一住院周期一期与分期双侧全膝关节置换疗效比较

doi: 10.3969/j.issn.1674-9081.2011.01.012
详细信息
    通讯作者:

    翁习生  电话:010-65296081, E-mail:xshweng@medmail.com.cn

  • 中图分类号: R687.4

Effectiveness and Safety of Simultaneous or Staggered Bilateral Total Knee Arthroplasty in One Hospitalization

More Information
  • 摘要:   目的  比较同一住院周期内进行一期双侧全膝关节置换(total knee arthroplasty, TKA)和分期双侧TKA的临床差异。  方法  回顾性分析2003至2008年因双膝原发性骨关节炎, 在本院一个住院周期内接受双膝关节表面置换手术且随访资料满2年的患者233例。根据双侧膝关节手术时间不同分为一期手术组和分期手术组, 分别比较两组患者术前因素、治疗因素和疗效间的差异。术前因素包括年龄、体重指数(体重kg/身高m2)、病程时间(从起病到手术)和术前合并症; 治疗因素包括术前住院时间、总住院时间、双侧手术总时间、双侧术中总止血带时间、双侧手术总引流量、总输血量; 疗效判定采用术前HSS评分、术后2年时HSS评分及HSS评分改善程度(末次与术前HSS评分的差值)作为量化标准, 并统计并发症的种类及例数。  结果  一期手术组患者191例(男性31例, 女性160例), 分期手术组患者42例(男性5例, 女性37例)。分期手术组术前合并症率明显高于一期手术组, 但两组年龄、体重指数、病程时间比较差异无统计学意义(P>0.05)。分期手术组总住院时间明显长于一期手术组(P < 0.01), 但一期手术组总输血量明显多于分期手术组(P < 0.01), 两组术前住院时间、总手术时间、总止血带时间、总引流量比较差异无统计学意义(P>0.05)。两组术前、术后2年时HSS评分比较差异无统计学意义(P>0.05)。一期手术组术后伤口并发症率高于分期手术组, 两组仅有小腿肌间静脉发生血栓, 且发病率比较差异无统计学意义。两组均无严重并发症发生、住院死亡率均为0。  结论  在合理选择患者并进行完善的术前准备下, 同一住院周期内一期双膝TKA和分期双膝TKA具有相同的安全性和临床效果。
  • 表  1  一期手术组与分期手术组治疗因素比较

    表  2  一期手术组与分期手术组疗效比较(分)

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出版历程
  • 收稿日期:  2010-10-11
  • 刊出日期:  2011-01-30

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