[1]陈文恒.双侧全膝关节置换术不同手术方案的临床疗效比较[J].新乡医学院学报,2017,34(12):1125-1127.[doi:10.7683/xxyxyxb.2017.12.021]
　CHEN Wen-heng.Comparison of curative effect of bilateral total knee replacement with different operation plan[J].Journal of Xinxiang Medical University,2017,34(12):1125-1127.[doi:10.7683/xxyxyxb.2017.12.021]
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双侧全膝关节置换术不同手术方案的临床疗效比较
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
34
期数:
2017年12
页码:
1125-1127
栏目:
临床研究
出版日期:
2017-12-05

文章信息/Info

Title:
Comparison of curative effect of bilateral total knee replacement with different operation plan
作者:
陈文恒
（驻马店市中心医院骨一科，河南　驻马店　463000）
Author(s):
CHEN Wen-heng
（Department of No.1 Orthopaedics，the Central Hospital of Zhumadian City，Zhumadian 463000，Henan Province，China）
关键词:
双侧全膝关节置换术; 手术方案; 疗效
Keywords:
bilateral knee joint replacement; operative strategies; curative effect
分类号:
R687.4
DOI:
10.7683/xxyxyxb.2017.12.021
文献标志码:
A
摘要:
目的　探讨双侧全膝关节置换术中采取一期手术、一次住院分期手术和分次住院进行手术的临床疗效。方法　选择2014年4月至2016年1月在驻马店市中心医院行双侧全膝关节置换术（TKA）的患者232例，根据手术方案分为同期组（n=98）、分期1组（n=85）及分期2组（n=49），全部患者均给予双膝TKA手术，其中同期组患者均在同次手术中完成双侧TKA手术，分期1组患者在一侧肢体手术后7～14 d对另一侧肢体进行手术，分期2组患者的两侧肢体手术间隔时间在 15 d 至1 a。比较3组患者的总手术时间、输血量、总住院时间及术后并发症，术后1 a采用美国特种外科医院（HSS）提出的评分标准对全部患者的膝关节功能进行评价。结果　分期1组和分期2组患者的输血量显著低于同期组（P<0.01），而总住院时间显著高于同期组（P<0.01）。分期1组和分期2组患者的输血量及总住院时间比较差异无统计学意义（P>0.05），3组患者的总手术时间两两比较差异均无统计学意义（P>0.05）。3组患者术后伤口感染、肺栓塞、下肢深静脉血栓及心血管系统并发症的发生率比较差异均无统计学意义（P>0.05）。3组患者术后1 a HSS评分均显著高于术前（P<0.05）。3组患者术后1 a HSS评分比较差异均无统计学意义（P>0.05）。结论　与同期TKA手术相比，分期TKA手术患者输血量少，住院时间长，但二者在改善膝关节功能方面均能取得较好的临床疗效，且手术安全性较为一致。
Abstract:
Objective　To explore curative effect of bilateral total knee replacement（TKA） under different operative strategies of one stage，several stages in a single hospitalization and several hospitalizations.Methods　Two hundred and thirty-two patients with bilateral total knee arthroplasty （TKA） were divided into same stage group （98 cases），stage 1 group （85 cases） and stage 2 group （49 cases） according to operative strategies，all the patients were given bilateral TKA.Patients in the same stage group were given bilateral TKA in the same stage，patients in stage 1 group were given one side operation，and the other side were given operation after 7 to 14 days，while the operation time interval were 15 days to one year in stage 2 group.The total operation time，blood transfusion and total hospital stay and postoperative complications were compared among the three groups.The knee joint function after one year of operation was evaluated by the score of the hospital for special surgery（HSS）.Results　Blood transfusion of stage 1 and 2 group was lower than that of the same stage group significantly （P<0.01），and total hospital stay was higher than that of the same stage group significantly （P<0.01）.There was no significant difference in blood transfusion between stage 1 group and stage 2 group（P>0.05）.There was no significant difference in total operation time among the three groups（P>0.05）.There was no significant difference in the incidence of postoperative complications including wound infection，pulmonary embolism，deep venous thrombosis of lower limb and cardiovascular system complications among the three groups（P>0.05）.One year after operation，the HSS scores of the three groups were significantly higher than those before operation （P<0.05），there was no significant difference in the and HSS score at one year after operation among the three groups （P>0.05）.Conclusion　Although the blood transfusion of patients in several stages operation is lower and the hosptital stay is longer than those in the one stage operation,both one stage and several stages operation can achieve better clinical effect in improving the function of knee joint，and the operation safety are consistent.

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更新日期/Last Update: 2017-12-05