中国骨与关节杂志
中國骨與關節雜誌
중국골여관절잡지
Chinese Journal of Bone and Joint
2013年
3期
150-154
,共5页
杜哲%李明%张元凯%李德强
杜哲%李明%張元凱%李德彊
두철%리명%장원개%리덕강
骨性关节炎%全膝关节置换%双侧%同期手术%疗效%并发症
骨性關節炎%全膝關節置換%雙側%同期手術%療效%併髮癥
골성관절염%전슬관절치환%쌍측%동기수술%료효%병발증
Osteoarthritis%Total knee arthroplasty (TKA)%Bilateral%Simultaneous surgery%Clinical efficiency%Complication
目的比较双膝人工关节同期置换与选择性单膝置换的临床效果.方法本研究回顾性分析2010年6月至2011年9月,山东大学齐鲁医院收治的因骨性关节炎行人工全膝关节置换术患者154例,分为双膝置换组与单膝置换组,通过记录两组患者术前与术后3、6个月,1年的 KSS 评分,WOMAC 指数(西安大略麦马斯特大学骨性关节炎指数可视化量表),VAS 评分(疼痛视觉模拟评分),术后并发症,住院时间,住院期间费用(假体费用除外)及术后复查影像学表现分析两组患者的临床效果,并以 SPSS13.0软件做统计学分析,P<0.05有统计学意义.结果双膝置换组患者51例(男8例,女43例);单膝置换组患者103例(男35例,女68例).术前两组年龄、性别、体重指数、病程时间、VAS 评分等比较差异无统计学意义(P>0.05).双膝置换组术后3、6个月,1年的 KSS 评分及 WOMAC 指数与单膝置换组差异无统计学意义(P>0.05),两组术后膝关节功能均得以改善,VAS 评分两组差异无统计学意义(P>0.05),但男性患者的痛觉阈值普遍较高.平均住院时间双膝组略长(P<0.05),住院费用(假体费用除外)双膝置换组高,(P<0.05).术后并发症双膝置换组高于单膝组,双膝置换组5例发生下肢深静脉血栓(9.80%),肺心脑血管并发症3例(5.88%),肺栓塞2例(3.92%).单膝组并发感染1例(0.97%).两组均无死亡病例.结论同期双膝人工关节置换和选择性单膝置换临床效果相当,但双膝同期置换住院时间长,术后血栓发生率及心肺脑血管并发症高,术前应予足够重视.
目的比較雙膝人工關節同期置換與選擇性單膝置換的臨床效果.方法本研究迴顧性分析2010年6月至2011年9月,山東大學齊魯醫院收治的因骨性關節炎行人工全膝關節置換術患者154例,分為雙膝置換組與單膝置換組,通過記錄兩組患者術前與術後3、6箇月,1年的 KSS 評分,WOMAC 指數(西安大略麥馬斯特大學骨性關節炎指數可視化量錶),VAS 評分(疼痛視覺模擬評分),術後併髮癥,住院時間,住院期間費用(假體費用除外)及術後複查影像學錶現分析兩組患者的臨床效果,併以 SPSS13.0軟件做統計學分析,P<0.05有統計學意義.結果雙膝置換組患者51例(男8例,女43例);單膝置換組患者103例(男35例,女68例).術前兩組年齡、性彆、體重指數、病程時間、VAS 評分等比較差異無統計學意義(P>0.05).雙膝置換組術後3、6箇月,1年的 KSS 評分及 WOMAC 指數與單膝置換組差異無統計學意義(P>0.05),兩組術後膝關節功能均得以改善,VAS 評分兩組差異無統計學意義(P>0.05),但男性患者的痛覺閾值普遍較高.平均住院時間雙膝組略長(P<0.05),住院費用(假體費用除外)雙膝置換組高,(P<0.05).術後併髮癥雙膝置換組高于單膝組,雙膝置換組5例髮生下肢深靜脈血栓(9.80%),肺心腦血管併髮癥3例(5.88%),肺栓塞2例(3.92%).單膝組併髮感染1例(0.97%).兩組均無死亡病例.結論同期雙膝人工關節置換和選擇性單膝置換臨床效果相噹,但雙膝同期置換住院時間長,術後血栓髮生率及心肺腦血管併髮癥高,術前應予足夠重視.
목적비교쌍슬인공관절동기치환여선택성단슬치환적림상효과.방법본연구회고성분석2010년6월지2011년9월,산동대학제로의원수치적인골성관절염행인공전슬관절치환술환자154례,분위쌍슬치환조여단슬치환조,통과기록량조환자술전여술후3、6개월,1년적 KSS 평분,WOMAC 지수(서안대략맥마사특대학골성관절염지수가시화량표),VAS 평분(동통시각모의평분),술후병발증,주원시간,주원기간비용(가체비용제외)급술후복사영상학표현분석량조환자적림상효과,병이 SPSS13.0연건주통계학분석,P<0.05유통계학의의.결과쌍슬치환조환자51례(남8례,녀43례);단슬치환조환자103례(남35례,녀68례).술전량조년령、성별、체중지수、병정시간、VAS 평분등비교차이무통계학의의(P>0.05).쌍슬치환조술후3、6개월,1년적 KSS 평분급 WOMAC 지수여단슬치환조차이무통계학의의(P>0.05),량조술후슬관절공능균득이개선,VAS 평분량조차이무통계학의의(P>0.05),단남성환자적통각역치보편교고.평균주원시간쌍슬조략장(P<0.05),주원비용(가체비용제외)쌍슬치환조고,(P<0.05).술후병발증쌍슬치환조고우단슬조,쌍슬치환조5례발생하지심정맥혈전(9.80%),폐심뇌혈관병발증3례(5.88%),폐전새2례(3.92%).단슬조병발감염1례(0.97%).량조균무사망병례.결론동기쌍슬인공관절치환화선택성단슬치환림상효과상당,단쌍슬동기치환주원시간장,술후혈전발생솔급심폐뇌혈관병발증고,술전응여족구중시.
Objective To compare the clinical effects of simultaneous bilateral total knee arthroplasty (TKA) and selective unilateral TKA. Methods A total of 154 patients with osteoarthritis had TKA from June 2010 to September 2011, whose data were retrospectively analyzed. These patients were divided into 2 groups: the bilateral TKA group and the unilateral TKA group. Based on the Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Visual Analogue Scale (VAS), postoperative complications, hospital stays, hospitalization costs (excluding the prostheses costs) and the postoperative imaging finds in both groups preoperatively and 3, 6 and 12 months after the surgery, the clinical effects was analyzed. The statistical analysis was done by using the Statistical Package for the Social Science (SPSS) 13.0 software, and P<0.05 meant that there were statistically significant significances. Results There were 51 patients in the bilateral TKA group, (including 8 males and 43 females), and 103 patients in the unilateral TKA group, (including 35 males and 68 females). Preoperatively there were no statistically significant significances between the 2 groups in the age, gender, body mass index, course time, VAS and so on (P>0.05). There were no statistically significant significances in the KSS and WOMAC between the bilateral TKA group and the unilateral TKA group 3, 6 and 12 months postoperatively (P>0.05). The knee function got improved in both groups postoperatively, and the differences in the VAS were not statistically significant (P>0.05). However, the threshold value of pain perception was commonly higher in male patients. The mean hospital stay was a little longer in the bilateral TKA group (P<0.05), and the hospitalization costs (excluding the prostheses costs) were also higher (P<0.05). The postoperative complications were more in the bilateral TKA group, when compared with those in the unilateral TKA group. 5 cases of lower limb deep venous thrombosis (DVT) (9.80%), 3 cases of cardiovascular and cerebrovascular diseases (5.88%) and 2 cases of pulmonary embolism (3.92%) occurred postoperatively in the bilateral TKA group. 1 case of joint infection was noted in the unilateral TKA group (0.97%). There were no death cases in both groups. Conclusions The simultaneous bilateral TKA is not superior to the selective unilateral TKA in the clinical efficiency, with longer hospital stay and more complications such as pulmonary embolism and cardiovascular and cerebrovascular diseases. So when the simultaneous bilateral TKA is performed, enough attention should be paid preoperatively.