中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2014年
11期
861-864
,共4页
李祖涛%徐江波%徐万龙%缪晓刚%袁宏
李祖濤%徐江波%徐萬龍%繆曉剛%袁宏
리조도%서강파%서만룡%무효강%원굉
膝关节%人工膝关节%关节成形术,置换,膝%外科手术%治疗方案
膝關節%人工膝關節%關節成形術,置換,膝%外科手術%治療方案
슬관절%인공슬관절%관절성형술,치환,슬%외과수술%치료방안
Knee joint%Knee prosthesis%Arthroplasty,replacement,knee%Surgical procedures,operative%Treatment protocols
目的：比较同一住院周期1次手术、同一住院周期分次手术与分次住院行双侧膝关节表面置换术( total knee arthroplasty，TKA )的疗效及其影响因素。方法回顾性分析2003年至2011年，在我科接受双膝关节表面置换的病例共378例，其中352例获得为期2年的随访。根据双侧膝关节手术间隔时间不同，分为同一住院周期1次手术组128例( A 组)、同一住院周期分次手术组118例( B 组)与分次住院组106例(C组)，比较3组患者术前因素、术后并发症、疗效差异。结果患者年龄A组(65.0±6.8)岁低于B组(70.8±7.6)岁和C组(70.2±7.7)岁，差异有统计学意义( P＜0.05)，B组与C组差异无统计学意义( P＞0.05)；术前合并症A组少于B，C两组，差异有统计学意义( P＜0.05)；总住院时间，A组(13.6±3.2)天，较B组(22.5±6.2)天与C组(27.4±7.3)天短，差异有统计学意义( P＜0.05)，后两组差异无统计学意义( P＞0.05)；围术期输血量，A组(732.4±375.1) ml，高于B组(501.7±207.2) ml和C组(510.9±208.8) ml，差异有统计学意义( P＜0.05)，而 B、C 两组间，差异无统计学意义( P＞0.05)；A，B，C 3组手术前后的 HSS 评分差值分别为(32.9±12.3)，(33.2±12.8)，(33.4±11.9)；围术期总出血量分别为(1071.6±112.3) ml，(986.4±121.7) ml，(1036.1±98.7) ml；总手术时间分别为(171.9±30.1) min，(183.7±32.2) min，(182.7±32.4) min；术后并发症的发生率及病死率A，B，C 3组差异均无统计学意义( P＞0.05)。结论在患者基础条件允许和充分的术前准备条件下，同期双膝置换可获得与分期双膝置换或分次住院行双膝关节置换同样的远期疗效。
目的：比較同一住院週期1次手術、同一住院週期分次手術與分次住院行雙側膝關節錶麵置換術( total knee arthroplasty，TKA )的療效及其影響因素。方法迴顧性分析2003年至2011年，在我科接受雙膝關節錶麵置換的病例共378例，其中352例穫得為期2年的隨訪。根據雙側膝關節手術間隔時間不同，分為同一住院週期1次手術組128例( A 組)、同一住院週期分次手術組118例( B 組)與分次住院組106例(C組)，比較3組患者術前因素、術後併髮癥、療效差異。結果患者年齡A組(65.0±6.8)歲低于B組(70.8±7.6)歲和C組(70.2±7.7)歲，差異有統計學意義( P＜0.05)，B組與C組差異無統計學意義( P＞0.05)；術前閤併癥A組少于B，C兩組，差異有統計學意義( P＜0.05)；總住院時間，A組(13.6±3.2)天，較B組(22.5±6.2)天與C組(27.4±7.3)天短，差異有統計學意義( P＜0.05)，後兩組差異無統計學意義( P＞0.05)；圍術期輸血量，A組(732.4±375.1) ml，高于B組(501.7±207.2) ml和C組(510.9±208.8) ml，差異有統計學意義( P＜0.05)，而 B、C 兩組間，差異無統計學意義( P＞0.05)；A，B，C 3組手術前後的 HSS 評分差值分彆為(32.9±12.3)，(33.2±12.8)，(33.4±11.9)；圍術期總齣血量分彆為(1071.6±112.3) ml，(986.4±121.7) ml，(1036.1±98.7) ml；總手術時間分彆為(171.9±30.1) min，(183.7±32.2) min，(182.7±32.4) min；術後併髮癥的髮生率及病死率A，B，C 3組差異均無統計學意義( P＞0.05)。結論在患者基礎條件允許和充分的術前準備條件下，同期雙膝置換可穫得與分期雙膝置換或分次住院行雙膝關節置換同樣的遠期療效。
목적：비교동일주원주기1차수술、동일주원주기분차수술여분차주원행쌍측슬관절표면치환술( total knee arthroplasty，TKA )적료효급기영향인소。방법회고성분석2003년지2011년，재아과접수쌍슬관절표면치환적병례공378례，기중352례획득위기2년적수방。근거쌍측슬관절수술간격시간불동，분위동일주원주기1차수술조128례( A 조)、동일주원주기분차수술조118례( B 조)여분차주원조106례(C조)，비교3조환자술전인소、술후병발증、료효차이。결과환자년령A조(65.0±6.8)세저우B조(70.8±7.6)세화C조(70.2±7.7)세，차이유통계학의의( P＜0.05)，B조여C조차이무통계학의의( P＞0.05)；술전합병증A조소우B，C량조，차이유통계학의의( P＜0.05)；총주원시간，A조(13.6±3.2)천，교B조(22.5±6.2)천여C조(27.4±7.3)천단，차이유통계학의의( P＜0.05)，후량조차이무통계학의의( P＞0.05)；위술기수혈량，A조(732.4±375.1) ml，고우B조(501.7±207.2) ml화C조(510.9±208.8) ml，차이유통계학의의( P＜0.05)，이 B、C 량조간，차이무통계학의의( P＞0.05)；A，B，C 3조수술전후적 HSS 평분차치분별위(32.9±12.3)，(33.2±12.8)，(33.4±11.9)；위술기총출혈량분별위(1071.6±112.3) ml，(986.4±121.7) ml，(1036.1±98.7) ml；총수술시간분별위(171.9±30.1) min，(183.7±32.2) min，(182.7±32.4) min；술후병발증적발생솔급병사솔A，B，C 3조차이균무통계학의의( P＞0.05)。결론재환자기출조건윤허화충분적술전준비조건하，동기쌍슬치환가획득여분기쌍슬치환혹분차주원행쌍슬관절치환동양적원기료효。
Objective To analyze the influence factors and compare the curative effects of simultaneous bilateral total knee arthroplasty ( TKA ) in 1 hospitalization period, staggered bilateral TKA in 1 hospitalization period or staggered bilateral TKA in 2 hospitalization periods.Methods From 2003 to 2011, 378 patients undergoing simultaneous and staged bilateral TKA were enrolled in the study, among whom 352 patients were followed up for at least 2 years. All the patients were divided into 3 groups based on the surgical intervals, including group A of simultaneous bilateral TKA in 1 hospitalization period (n=128 ), group B of staggered bilateral TKA in 1 hospitalization period (n=118 ) and group C of staggered bilateral TKA in 2 hospitalization periods (n=106 ). A retrospective review of each group was conducted to compare the preoperative factors, postoperative complications and differences of curative effects.Results The average age in group A was ( 65.0±6.8 ) years old, who were older than ( 70.8±7.6 ) years old in group B and ( 70.2±7.7 ) years old in group C, and the differences were statistically signiifcant (P<0.05 ). The differences in the average age between group B and group C were not statistically signiifcant (P>0.05 ). The preoperative complications of group A were less than that in group B and group C, and the differences were statistically signiifcant (P<0.05 ). The total duration of hospitalization was ( 13.6±3.2 ) d in group A, which was shorter than ( 22.5±6.2 ) d in group B and ( 27.4±7.3 ) d in group C, and the differences were statistically signiifcant (P<0.05 ). The differences in the total duration of hospitalization between group B and group C were not statistically significant (P>0.05 ). The perioperative blood transfusion volume in group A was ( 732.4±375.1 ) ml, which was larger than ( 501.7±207.2 ) ml in group B and ( 510.9±208.8 ) ml in group C, and the differences were statistically signiifcant (P<0.05 ). The differences in the perioperative blood transfusion volume between group B and group C were not statistically signiifcant (P>0.05 ). The difference value between the preoperative Hospital for Special Surgery ( HSS ) score and the postoperative score was ( 32.9±12.3 ), ( 33.2±12.8 ) and ( 33.4±11.9 ) respectively in 3 groups. The total perioperative blood loss was ( 1071.6±112.3 ) ml, ( 986.4±121.7 ) ml and ( 1036.1±98.7 ) ml, and the total operation time was ( 171.9±30.1 ) min, ( 183.7±32.2 ) min and ( 182.7±32.4 ) min respectively. The differences in the postoperative complication and mortality rate were not statistically significant among the 3 groups (P>0.05 ). Conclusions With well preoperative preparation and reasonable patient selection, the same long-term curative results can be achieved in simultaneous bilateral TKA in 1 hospitalization period as in staggered bilateral TKA in 1 hospitalization period or in staggered bilateral TKA in 2 hospitalization periods.
