不同月经周期阶段妇女行单侧全髋关节置换术出血情况分析

发布时间：2018-05-20 22:36

  本文选题：人工关节置换术 + 月经周期　； 参考：《中国人民解放军医学院》2017年硕士论文

【摘要】：全髋关节置换术是处理髋关节终末期疾病最行之有效的解决方案之一,可很大程度上提高髋关节功能,改善步态,缓解疼痛,中远期疗效肯定。近年来,年轻非绝经期女性罹患终末期髋部疾病数量逐年增多,随着人们经济水平提高、社会观念改变、医学领域的进步以及假体设计理念的更新,越来越多的年轻女性选择行人工全髋关节置换术来彻底解决疼痛,纠正步态及恢复髋部功能,以适应更好的工作岗位和社会地位。月经周期是非绝经期女性特有的生理周期变化,随着月经周期的变化,妇女体内激素水平同样呈周期性变化,既往传统观念认为经期妇女凝血机制异常,易产生过多的出血,而出血过多引起的贫血、低血压、凝血障碍、感染等并发症风险让术者担忧。目的分析妇女不同月经周期阶段行人工全髋关节置换术对术中出血及总出血量的影响。方法回顾分析2010年8月-2017年2月于我院诊断为股骨头坏死,髋关节骨性关节炎,先天性髋臼发育不良伴脱位(Crowe Ⅰ-Ⅱ型)行单侧人工全髋关节置换术的非绝经期女性250例,年龄19-40 (31.28±5. 72)岁,依患者月经周期,将患者分为月经期组(n=36)、卵泡期组(n=129)、排卵期组(n=51)和黄体期组(n=34)。比较四组患者术中出血及总出血量的差异。结果术中出血量卵泡期组为(318. 60±186. 25 ) ml, 排卵期组为(296. 67±230. 45 ) ml,黄体期组为(341.18±260. 67) ml,月经期组为(297. 22±187.44) ml,四组之间差异无统计学意义(P=0.743)。总出血量卵泡期组为(843. 40±514. 98) ml,排卵期组为(741.71 ±420. 83 ) ml,黄体期组为(898. 44±422. 68 ) ml,月经期组为(760. 53±360. 27) ml,四组之间差异同样无统计学意义(P = 0.347)。结论月经期为患者行人工全髋关节置换术,对术中出血及总出血量的影响不显著。
[Abstract]:Total hip replacement is one of the most effective solutions for the treatment of end-stage hip diseases. It can greatly improve hip function, improve gait and relieve pain. In recent years, the number of young and non-menopausal women suffering from end-stage hip diseases has increased year by year, as people's economic level has improved, social attitudes have changed, the medical field has advanced and the concept of prosthetic design has been updated. More and more young women choose artificial total hip replacement to completely solve the pain, correct gait and restore hip function in order to adapt to better job and social status. The menstrual cycle is unique to women in the non-menopausal period. With the change of menstrual cycle, the hormone level in women's body also changes periodically. The traditional view is that the coagulation mechanism of women in menstrual period is abnormal, and it is easy to cause excessive bleeding. The risk of complications such as anaemia, hypotension, clotting disorder, and infection caused by excessive bleeding is a concern to the operator. Objective to analyze the effect of artificial total hip arthroplasty (THR) on intraoperative bleeding and total bleeding in women with different menstrual cycles. Methods from August 2010 to February 2017, 250 non-menopausal women who were diagnosed as osteonecrosis of femoral head, osteoarthritis of hip, congenital acetabular dysplasia with dislocation of Crowe 鈪，

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