摘要
目的讨论膝关节骨性关节炎（OA）与类风湿关节炎（RA）患者全膝人工关节置换术（TKR）术前检查的区别及注意事项。方法回顾性分析接受TKR的OA患者（362例）与RA患者（91例）术前检查结果。结果OA患者年龄高于RA患者[（66．55±7．78）岁比（58．93±13．46）岁，P〈0．05]。OA患者合并糖尿病占26．52％（96／362），RA患者占37．36％（34／91），两者比较差异有统计学意义（P〈0．05）；OA患者合并腰椎病变占33．43％（121／362），RA患者占23．08％（21／91），两者比较差异无统计学意义（P〉0．05）。OA患者体质指数（27．71±3．98）kg／m^2，红细胞压积0．38±0．05，血红蛋白（130．17±17．59）g／L，明显高于RA患者的（24．37±4．30）kg／m^2,0．33±0．06、（111．45±18．56）g／L，差异有统计学意义（P〈0．01）。OA患者红细胞沉降率（27．77±27．66）mm／1h，C反应蛋白（17．23±27．66）mg／L，D．二聚体（268．54±299．83）μg／L，明显低于RA患者的（59．76±32．00）mm／1h、（30．00±32．27）mg／L、（990．09±550．91）μg／L，差异有统计学意义（P〈0．01或〈0．05）。OA患者无使用激素病例，RA患者有8例（8．8％，8／91）使用激素，两者比较差异有统计学意义（P〈0．01）。两者泌尿系感染情况比较差异无统计学意义（P〉0．05）。结论在OA与RA患者TKR术前检查中发现明显的不同，根据不同着重处理各种合并症，正确指导围手术期的治疗，以保证手术安全进行。
Objective To discuss the difference of preoperative examination and matters needing attention between osteoarthritis （OA） and rheumatoid arthritis （RA） patients who received total knee replacement （TKR）. Methods Preoperative examination results were analyzed retrospectively between OA patients （362 cases） and RA patients （91 cases） who received TKR. Results The age of OA patients was significantly higher than RA patients [ （ 66.55 ± 7.78 ） years vs. （ 58.93 ± 13.46 ） years, P 〈 0.05 ]. There was significant difference in rate of diabetes between OA and RA patients [26.52% （96/362） vs. 37.36% （34/91）,P 〈 0.05 ]. There was no significant difference in the rate of lumbar vertebrae disease between OA and RA patients [33.43%（121/362） vs. 23.08%（21/91 ）,P〉 0.05]. The body mass index,haematocrit and hemoglobin in OA patients were significantly higher than those in RA patients [（27.71 ± 3.98） kg/m^2 vs. （24.37 ±4.30） kg/m^2,0.38±0.05 vs. 0.33±0.06, （130.17± 17.59） g/L vs. （111.45± 18.56）g/L,P 〈 0.01 ]. The erythrocyte sedimentation rate, C-reactive protein and D-dimer in OA patients were significantly lower than those in RA patients [ （27.77 ± 27.66） mm/1 h vs. （59.76 ± 32.00） mm/1 h, （ 17.23 ± 27.66） mg/L vs. （ 30.00± 32.27 ） mg/L, （ 268.54 ± 299.83 ） μg/L vs. （990.09 ± 550.91 ） μg/L, P 〈 0.01 or 〈 0.05 ]. The rate of using glueocortieoid in RA patients was significantly higher than OA patients [ 8.8%（ 8/91 ） vs. 0, P 〈 0.01 ]. There was no significant difference in the rate of urinary system infection （P 〉 0.05 ）. Conclusions The preoperative examination is found significantly different between OA and RA patients who received TKR. According to different focuses on, dealing with various kinds of complications and correct guidance on preoperative treatment, can ensure the safety of operation.
出处
《中国医师进修杂志》
2012年第32期21-23,共3页
Chinese Journal of Postgraduates of Medicine
关键词
膝关节
骨关节炎
关节炎
类风湿
Knee joint
Osteoarthritis
Arthritis,rheumatoid
