成人双侧高位发育性髋关节脱位行同期和分期人工全髋关节置换术围手术期并发症比较分析
发布时间：2018-11-11 13:52
【摘要】：背景:成人双侧高位DDH(Hartofilakidis III型)同期与分期行人工全髋关节置换术疗效的比较性研究不多。目的:通过对比成人双侧高位DDH(Hartofilakidis III型)同期、分期行THA术围手术期安全性及相关临床指标,从而实行最佳治疗方案,以此把并发症比例最小化,达到更满意临床疗效。方法:2004年9月-2015年7月在我院施行双侧人工全髋关节置换术的57例双侧高位发育性髋关节脱位(Hartofilakidis III型)的成人病人分为同期组(26例)和分期组(31例)。两组分别行同期及分期手术。对比两组总出、输血量、总住院时间、手术前后Harris评分和术中、术后并发症发生情况。结果:57例患者(114髋)均获得临床随访,围手术期共出现17例并发症。两组性别、年龄、总出血量、总并发症发生率、术前、术后Harris评分无统计学差异,同期组合和分期组均无死亡病人,同期组总输血率高于分期组,差异有统计学意义(P0.05),总住院时间低于分期组差异有统计学意义(P0.05)。结论:同期组总并发症发生率高于分期组,但无统计学差异,成人双侧高位DDH施行THA同期与分期安全性无区别,且具有住院时间短等优点,医生可于术前仔细评估患者全身状况,依据患者具体情况选择手术方案,同时防止出现围手术期并发症。
[Abstract]:Background: there are few comparative studies on the efficacy of artificial total hip arthroplasty in adults with bilateral high DDH (Hartofilakidis III. Objective: to compare the perioperative safety and related clinical indexes of bilateral high DDH (Hartofilakidis III in adults by staging THA in order to minimize the incidence of complications and to achieve a more satisfactory clinical effect. Methods: from September 2004 to July 2015, 57 adult patients undergoing bilateral total hip replacement (Hartofilakidis III) were divided into two groups: the same group (n = 26) and staging group (n = 31). The two groups were operated at the same time and by stages. Total output, blood transfusion, total hospital stay, Harris score before and after operation, intraoperative and postoperative complications were compared between the two groups. Results: all the 57 patients (114 hips) were followed up and 17 cases of complications occurred in perioperative period. There was no significant difference in sex, age, total bleeding volume, total complication rate, Harris score before and after operation between the two groups. There were no dead patients in the combination group and staging group, and the total blood transfusion rate in the same period group was higher than that in the staging group. The difference was statistically significant (P0.05), and the total hospitalization time was lower than that of staging group (P0.05). Conclusion: the incidence of total complications in the same period group is higher than that in the staging group, but there is no statistical difference between the two groups. There is no difference in the safety between the simultaneous and staging of bilateral high DDH in adults, and it has the advantages of short hospital stay and so on. The doctor can evaluate the patient's whole body condition carefully before operation, choose the operation plan according to the patient's specific condition, and prevent the perioperative complication at the same time.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4
本文编号：2325018
[Abstract]:Background: there are few comparative studies on the efficacy of artificial total hip arthroplasty in adults with bilateral high DDH (Hartofilakidis III. Objective: to compare the perioperative safety and related clinical indexes of bilateral high DDH (Hartofilakidis III in adults by staging THA in order to minimize the incidence of complications and to achieve a more satisfactory clinical effect. Methods: from September 2004 to July 2015, 57 adult patients undergoing bilateral total hip replacement (Hartofilakidis III) were divided into two groups: the same group (n = 26) and staging group (n = 31). The two groups were operated at the same time and by stages. Total output, blood transfusion, total hospital stay, Harris score before and after operation, intraoperative and postoperative complications were compared between the two groups. Results: all the 57 patients (114 hips) were followed up and 17 cases of complications occurred in perioperative period. There was no significant difference in sex, age, total bleeding volume, total complication rate, Harris score before and after operation between the two groups. There were no dead patients in the combination group and staging group, and the total blood transfusion rate in the same period group was higher than that in the staging group. The difference was statistically significant (P0.05), and the total hospitalization time was lower than that of staging group (P0.05). Conclusion: the incidence of total complications in the same period group is higher than that in the staging group, but there is no statistical difference between the two groups. There is no difference in the safety between the simultaneous and staging of bilateral high DDH in adults, and it has the advantages of short hospital stay and so on. The doctor can evaluate the patient's whole body condition carefully before operation, choose the operation plan according to the patient's specific condition, and prevent the perioperative complication at the same time.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4
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