摘要
[目的]比较双侧人工膝关节同期置换和分期置换的近期疗效。[方法]回顾性分析本科室2013年8月～2015年7月完成双侧人工膝关节置换的病例135例,其中,同期置换67例,分期置换68例。比较两组患者术前情况、失血量、输血量、住院时间、住院费用、围手术期并发症,以及术后6个月关节功能恢复情况。[结果]两组患者术前一般资料比较差异无统计学意义(P>0.05)。同期置换组住院时间、住院费用方面明显少于分期组,差异有统计学意义(P<0.05),而同期组失血量、输血量及围术期总并发症发生率等均高于分期置换组,差异有统计学意义(P<0.05)。术后6个月,两组患者的症状与关节功能均较术前明显改善,但两组间在VAS评分、ROM、HSS评分和并发症方面的差异均无统计学意义(P<0.05)。[结论]双侧人工膝关节同期置换较分期置换住院时间短、住院费用低,但手术风险大。建议对高龄(年龄>70周岁)、伴有严重基础疾病或肥胖症患者采用分期置换手术。
[Objective] To compare the short-term clinical outcomes of simultaneous bilateral total knee arthroplasty ver-sus staged bilateral total knee arthroplasty（TKA）. [Methods] A retrospective study was done on 135 patients who underwent bi-lateral TKA from August 2013 to July 2015. Of them, 67 patients had bilateral TKA performed simultaneously at one-stage op-eration（the one-stage group）, while the remaining 68 patients received bilateral TKA by two stages（the staged group）. The pre-operative condition, blood loss, blood transfusion, hospital stay, hospital expenses and perioperative complications, as well asjoint function at 6 months postoperatively were compared between the two groups. [Results] There was no significant differencein the preoperative data between the two groups（P〉0.05）. The one-stage group took significantly shorter hospital stay and lesshospital expenses than the staged group（P〈0.05）, although the former had significantly more blood loss, more blood transfusionpostoperntively, and higher total complication rate than the latter（P〈0.05）. At 6 months after operation the knee function signif-icantly improved in both groups compared with that before operation（P〈0.05）, whereas no statistically significant differences re-garding to VAS, ROM and HSS score were found between the two groups（P〉0.05）. [Conclusion] The simultaneous bilateralTKA takes shorter hospital time and less hospital expenses, while higher risk of complication than the staged bilateral TKA. It issuggested that the patients aged more than 70 years, accompanied with severe underlying disease or obesity should be candi-dates of staged bilateral TKA.
作者
孙卫平
邹华强
王善超
SUN Wei-ping;ZOU Hua-qiang;WANG Shan-chao(No.1 Orthopedic Surgery Department,No.404 Hospital of PLA,Weihai 264200,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2018年第21期1942-1946,共5页
Orthopedic Journal of China
关键词
膝
同期置换
分期置换
keen
simultaneous bilateral total knee arthroplasty
staged bilateral total knee arthroplasty
