双侧同期和分期全膝关节置换的临床对比

发布时间：2018-04-03 19:51

本文选题：全膝关节置换　切入点：同期　出处：《兰州大学》2017年硕士论文

【摘要】：目的:分析比较对于膝关节OA(osteoarthritis,OA)患者双侧同期和分期行TKA(total knee arthroplasty,TKA)的手术后并发症和临床效果,并探讨同期行双侧TKA的安全可行性。方法:收集2014年1月—2016年3月期间在我院接受双侧TKA的70例双侧膝关节重度骨性关节炎患者的临床资料,将其中34例双侧同期行TKA患者纳入同期组,其中36例双侧分期行TKA患者纳入分期组,分析比较两组患者的一般资料、术前合并疾病情况、术中术后的出血量及输血量、手术并发症、手术前及手术后一年膝关节HSS评分及ROM(range of motion,ROM)、住院时间及费用等指标。结果:两组患者在一般资料、手术前合并症发生率以及手术并发症发生率方面差异无统计学意义(P0.05);同期组住院时间短于分期组,结果存在统计学意义(P0.05);分期组住院总费用多于同期组,但出血量及输血量少于同期组,均存在统计学上意义(P0.05);两组患者手术前、手术后一年膝关节HSS评分及ROM相比,均不具有统计学意义(P0.05)。结论:对于双侧膝关节OA患者,双侧同期与双侧分期TKA具有相同的临床疗效,且不增加手术的风险及并发症发生率,具有缩短患者住院时间、节省住院花费、减少患者痛苦等多方面优势。对于双侧膝关节OA患者,全面评估患者基本状况,在基本状况相对较好的条件下,可以双侧同期行TKA。
[Abstract]:Objective: to compare the postoperative complications and clinical results of bilateral TKA(total knee arthroplasty in patients with osteoarthritis of knee, and to explore the safety and feasibility of bilateral TKA at the same time.Methods: the clinical data of 70 patients with bilateral severe osteoarthritis of knee joint who received bilateral TKA in our hospital from January 2014 to March 2016 were collected, and 34 cases of bilateral TKA were included in the same group.Thirty-six patients with bilateral TKA were included in the staging group. The general data of the two groups were analyzed and compared, including the preoperative complicated disease, the amount of blood lost during and after operation, the amount of blood transfusion, the complications of the operation.HSS score, ROM(range of motion rom, hospitalization time and cost were measured before and one year after operation.Results: there was no significant difference in general data, incidence of complications and complications between the two groups (P 0.05), and the hospitalization time of the two groups was shorter than that of the staging group.There was no statistical significance of P0.05.Conclusion: for patients with bilateral knee osteoarthritis, bilateral simultaneous and bilateral staging TKA has the same clinical efficacy, and does not increase the risk of surgery and the incidence of complications, it can shorten the hospitalization time of patients and save the cost of hospitalization.Reduce patient suffering and other advantages.For patients with bilateral knee osteoarthritis, the basic condition of the patients was comprehensively evaluated, and TKA could be performed at the same time under the condition of relatively good basic condition.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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