| 陈迪嘉,朱先洋,祝蒙见,等.不同间隔时间双侧膝关节置换术的安全性与经济成本对比.骨科,2017,8(3): 218-222. |
| 不同间隔时间双侧膝关节置换术的安全性与经济成本对比 |
| Safety and efficacy of bilateral total knee arthroplasty in different time intervals |
| 投稿时间：2016-12-02 |
| DOI：10.3969/j.issn.1674-8573.2017.03.013 |
| 中文关键词: 关节成形术，置换，膝 骨关节炎 对比研究 |
| 英文关键词: Arthroplasty, replacement, knee Osteoarthritis Comparative study |
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| 中文摘要: |
| 目的 比较不同间隔时间的双侧全膝关节置换术（total knee arthroplasty, TKA）的安全性与经济成本。方法 回顾性分析我院2011年4月至2015年11月收治的双侧膝骨性关节炎病人155例，按照双侧TKA手术的间隔时间分为三组，一期完成手术者52例纳入一期组，非同一入院周期行分期TKA的51例纳入非同期分期组，同一入院周期行TKA的52例纳入同期分期组。记录三组病人的术前一般资料、手术时间、输血率、平均输血量、住院时间、住院费用、术后并发症、术后美国特种外科医院（the hospital for special surgery, HSS）膝关节评分及疼痛视觉模拟量表（visual analogue scale, VAS）评分。结果 三组病人术后各时间点的HSS评分、VAS评分比较，差异均无统计学意义（P均＞0.05）；一期组的手术时间最短、住院时间最短、住院费用最低，但输血率及平均输血量最多；非同期分期组的住院时间最长、住院费用最高；同期分期组的住院时间及费用均居中。三组均无感染及死亡病例，一期组发生下肢深静脉血栓1例（1.92%）、心脑血管疾病3例（5.77%）、切口愈合不良2例（3.85%），并发症总发生率为11.54%；非同期分期组和同期分期组各发生2例切口愈合不良（3.92%、3.85%）。结论 对于术前一般情况相对较差且必须行双侧TKA的病人，同一入院周期内行分期手术是一种更安全、经济的手术方式。 |
| 英文摘要: |
| Objective To compare the safety and efficacy of bilateral total knee arthroplasty (TKA) performed in different time intervalls. Methods We retrospectively compared 155 patients with osteoarthritis who had undergone TKA from April 2011 to November 2015. These patients were divided into three groups: simultaneous bilateral TKA group (SBTKA group), staged bilateral TKA in the same admission period group (same admission group) and staged bilateral TKA in different admission period group (different admission group). We recorded the operative time, blood transfusion rate, length of hospital stay, hospitalization cost, the hospital for special surgery (HSS) scores, visual analogue scale (VAS) scores and postoperative complications. Results There were no statistically significant differences in HSS and VAS scores (P＞0.05 for all). The operative time, length of hospital stay and the cost in SBTKA group were increased as compared with the rest two groups, however, the blood transfusion rate was the highest. The length of hospital stay and the cost in the same admission group were increased most significantly in three groups, while those in the different admission group were placed in the middle. There were no infection and death cases, but 1 case of lower limb deep venous thrombosis (DVT) (1.92%), 3 cases of cardiovascular diseases (5.77%) and 2 cases of poor wound healing (3.85%) in SBTKA group, 2 cases of poor wound healing each in same admission group and different admission group. Conclusion Staged bilateral TKA in the same admission period could be safe and effective for patients with poor preoperative conditions and the need for bilateral TKA. |
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