同期或分期全膝关节置换术治疗高龄双膝关节骨关节炎的疗效

发布时间：2018-07-01 11:30

本文选题：全膝关节置换术 + 双膝关节骨关节炎　；参考：《中国老年学杂志》2017年05期

【摘要】：目的探讨同期或分期全膝关节置换术(TKA)治疗高龄双侧膝关节骨关节炎(KOA)的疗效。方法 TKA手术治疗的KOA高龄患者122例,根据患者接受的治疗方案进行分组,同次麻醉情况下进行同期双侧TKA治疗组(同期双侧组)55例,相同住院周期内进行分次双侧TKA治疗组(分次双侧组)27例,不同住院周期条件进行的分期双侧TKA治疗组(分期双侧组)40例。对比各组患者的手术相关指标,术前及术后6个月对各组美国特种外科医院(HSS)膝关节评分、西安大略和麦克马斯特大学(WOMAC)骨关节炎指数进行评定,记录各组并发症。结果分次双侧组及分期双侧组的手术时间和住院时间以及住院费用均分别明显大于同期双侧组,但输血量以及术后引流量均明显少于同期双侧组(均P0.05)。各组患者术前及术后6个月的关节功能评分对比(P0.05)。分次双侧组及分期双侧组的并发症总发生率,均明显低于同期双侧组(P0.05)。结论分期或分次TKA治疗高龄双膝KOA患者的疗效与同期TKA基本类似,但同期TKA术式通常并发症发生率更高,值得临床重视。
[Abstract]:Objective to investigate the effect of simultaneous or phased total knee arthroplasty (TKA) in the treatment of senile bilateral knee osteoarthritis (KOA). Methods 122 cases of KOA aged patients treated by TKA were divided into groups according to the treatment plan accepted by the patients and 55 cases of bilateral TKA treatment group (bilateral group) at the same time under the same time of anesthesia, the same hospitalization cycle was within the same period. 27 cases were divided into bilateral TKA treatment group (divided bilateral group) and 40 cases of bilateral TKA treatment group (staging bilateral group) in different period of hospitalization period. Compare the operation related indexes of each group. Before and 6 months after operation, the knee joint score of American special surgical hospital (HSS), Xi'an grand strategy and McMaster University (WOMAC) bone joint The inflammatory index was evaluated and the complications were recorded in each group. Results the operation time, hospitalization time and hospitalization cost in the bilateral and bilateral groups were significantly higher than those in the same period, but the amount of blood transfusion and the postoperative flow rate were significantly less than that of the same period bilateral group (all P0.05). The joint function score of the patients in each group before and 6 months after the operation Comparison (P0.05). The total incidence of complications in both bilateral and bilateral groups was significantly lower than that in the same period (P0.05). Conclusion the curative effect of staging or graded TKA treatment for elderly double knee KOA patients is similar to that of TKA at the same time, but the common complication rate of TKA operation is higher in the same period, which deserves clinical attention.
【作者单位】：兰州大学第一临床医学院兰州大学第一医院骨科;
【分类号】：R687.4

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