>
网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们在线留言
最新消息:
双侧同期与分期非骨水泥型人工全髋关节置换术的安全性对比与分析
作者:杨立宇  杨礼庆  付勤 
单位:中国医科大学附属盛京医院 骨科, 辽宁 沈阳 110003
关键词:非骨水泥型人工全髋关节置换术 双侧 平均住院日 输血量 输血率 并发症 
分类号:R687.4
出版年·卷·期(页码):2017·36·第四期(518-523)
摘要:

目的:比较行双侧同期非骨水泥型人工全髋关节置换术与行双侧分期非骨水泥型人工全髋关节置换术的安全性与并发症发生情况。方法:对本院2012年3月至2015年3月53例行双侧非骨水泥型人工全髋关节置换术的患者进行回顾性分析,其中双侧同期置换25例(50髋),双侧分期置换28例(56髋)。比较两组术后血红蛋白和血细胞比容及其改变,术中术后输血量及输血率,手术时间及住院时间,以及术后并发症的发生情况。结果:双侧同期非骨水泥型人工全髋关节置换术在平均住院日方面较双侧分期全髋置换明显缩短[(21.32±5.92)d vs(32.93±11.12)d,P<0.05];术后输血量[(447.60±104.86)ml vs(245.00±70.00)ml,P<0.05]、总输血量[(726.20±129.79)ml vs(541.57±124.44)ml,P<0.05]及总输血率[76%vs 51.7%,P<0.05],双侧同期置换术较双侧分期置换术有所增加;双侧同期非骨水泥型全髋置换术后发生并发症的比例较双侧分期置换的略低(8%vs 17.8%),但差异无统计学意义(P>0.05)。结论:双侧同期非骨水泥型人工全髋置换术较双侧分期非骨水泥型人工全髋关节置换术明显降低平均住院日,但增加术后总输血量和总输血率,而术后并发症的发生无显著差异。

Objective:To evaluate the clinical outcome and complications of simultaneous and staged cementless bilateral total hip arthroplasty. Methods:From March 2012 to March 2015, 53 patients with bilateral total hip arthroplasty were retrospectively analyzed, including 25 patients with simultaneous bilateral total hip arthroplasty and 28 patients with staged bilateral total hip arthroplasty. We compared the values and changes of postoperative hemoglobin and hematocrit, amounts and rates of transfusion during and after operations, operation time and length of hospital stay and complications between the two groups. Results:Shorter length of hospital stay was found in the group of simultaneous bilateral total hip arthroplasty with(21.32±5.92) d vs (32.93±11.12) d(P<0.05). More blood were transfused in the group of simultaneous bilateral total hip arthroplasty[(447.60±104.86) d vs (245.00±70.00)ml,P<0.05].The similar outcome was presented in the total amount of transfusion with (726.20±129.79) ml vs (541.57±124.44)ml(P<0.05). Rates of transfusion of the overall treatment process was higher in the group of simultaneous cementless bilateral total hip arthroplasty than the staged group, with 76% vs 51.7%(P<0.05). Fewer complications happened in the group of simultaneous group than that in staged group (8%) vs 17.8%), but with no significance (P>0.05). Conclusion:Shorter length of hospital stay is presented by simultaneous cementless bilateral total hip arthroplasty, while the problems of more amounts of postoperative and total blood transfusion and higher rates of blood transfusion of the overall treatment process come up with simultaneous cementless bilateral total hip arthroplasty. In our study, no difference of complications can be found between the two groups.

参考文献:

[1] BEREND K R, LOMBARDI A V, ADAMS J B. Simultaneous vs staged cementless bilateral total hip arthroplasty:perioperative risk comparison[J].J Arthroplasty,2007,22(6 Suppl 2):111-115.
[2] KIM Y, KWON O R, KIM J S. Is one-stage bilateral sequential total hip replacement as safe as unilateral total hip replacement[J]. J Bone Joint Surg Br,2009,91(3):316-320.
[3] TROJANI C, d'OLLONNE T, SARAGAGLIA D, et al. One-stage bilateral total hip arthroplasty:functional outcomes and complications in 112 patients[J].Orthop Traumatol Surg Res,2012,98(6 Suppl):S120-123.
[4] TSIRIDIS E, PAVLOU G, CHARITY J,et al. The safety and efficacy of bilateral simultaneous total hip replacement:an analysis of 2063 cases[J].J Bone Joint Surg Br,2008,90(8):1005-1012.
[5] GARLAND A, ROLFSON O, GARELLICK G,et al. Early postoperative mortality after simultaneous or staged bilateral primary total hip arthroplasty:an observational register study from the Swedish Hip Arthroplasty Register[J].BMC Musculoskelet Disord, 2015, 8(16):77.
[6] LINDBERG-LARSEN M, JOERGENSEN C C, HUSTED H, et al. Simultaneous and staged bilateral total hip arthroplasty:a Danish nationwide study[J].Arch Orthop Trauma Surg,2013,133(11):1601-1605.
[7] BHAN S, PANKAJ A, MALHOTRA R.One-or two-stage bilateral total hip arthroplasty:a prospective, randomised, controlled study in an Asian population[J].J Bone Joint Surg Br,2006,88(3):298-303.
[8] PARVIZI J, TARITY T D, SHEIKH E, et al.Bilateral total hip arthroplasty:one-stage versus two-stage procedures[J].Clin Orthop Relat Res,2006,453:137-141.
[9] AGHAYEV E, BECK A, STAUB LP, et al. Simultaneous bilateral hip replacement reveals superior outcome and fewer complications than two-stage procedures:a prospective study including 1819 patients and 5801 follow-ups from a total joint replacement registry[J].BMC Musculoskelet Disord,2010,11:245.
[10] 刘颖赵,郭开今,李洪伟,等. 人工全髋关节置换术后患者关节功能评估及影响因素研究[J]. 现代医学,2016,44(10):1345-1349.
[11] 项鹏,余斌,熊军,等.双侧髋关节同期与分期置换临床疗效与安全性的Meta分析[J].中国矫形外科杂志,2012,20(4):289-294.
[12] 李毓灵,傅峥,张健.同期与分期行双侧全髋关节置换术的短期临床结果比较[J]. 中华创伤杂志,2013,29(7):637-640.
[13] 贾林,刘雪海,冯燕茹.人工髋关节置换术中并发症分析[J].中国矫形外科杂志,2010,18(12):976-978.
[14] MARTIN G R, MARSH J D, VASARHELYI E M, et al. A cost analysis of single-stage bilateral versus two-stage direct anterior total hip arthroplasty[J].Hip Int,2016,26(1):15-19.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 119591 位访问者

copyright ©《东南大学学报(医学版)》编辑部
联系电话:025-87232483 83272481
电子邮件: bjb@pub.seu.edu.cn