摘要
背景:由于行膝关节置换的患者多为双侧病变,在采取双侧膝关节同期置换还是单侧置换上一直存在着争议,争论的焦点是双侧同期置换是否可在保证不增加手术风险的前提下使修复效果得到确实的提升,对于此问题人们一直没有形成共识。目的:从安全性、经济性、成效性3个角度对同期双侧与单侧全膝关节置换进行对比分析。方法:选择安徽医科大学第一附属医院关节与骨肿瘤外科于2011年4月至2014年4月收治的因重度双侧膝骨关节炎行全膝关节置换的患者118例,根据置换方案分为2组,同期双侧置换组47例,单侧置换组71例。设定反映安全性、经济性、成效性的指标进行归集,最终通过对比、评价得出结论。结果与结论:同期双侧置换组与单侧置换组在安全性方面差异无显著性意义(P>0.05),但在经济性、成效性上,同期双侧置换组显著优于单侧置换组(P<0.05)。提示在同一严格的手术管理条件下,以及患者耐受的情况下,更倾向于行同期双侧全膝关节置换。但对置换前合并心血管疾病者,行同期双侧全膝关节置换要持慎重态度。置换前合并糖尿病者,要注意置换后感染的监控。
BACKGROUND： Patients with knee arthroplasty mostly had bilateral lesions. It is still controversial to perform simultaneous bilateral surgery or unilateral arthroplasty. The focus of controversy is that bilateral arthroplasty of the same period can get a real upgrade of the repair effect if it does not increase the risk of surgery. There have always existed controversies.OBJECTIVE： To comparatively analyze simultaneous bilateral and unilateral arthroplasty from aspects of safety, economy and effects. METHODS： 118 patients suffering from severe bilateral knee osteoarthritis and treated by total knee arthroplasty in the First Affiliated Hospital of Anhui Medical University from April 2011 to April 2014 were divided into simultaneous bilateral arthroplasty group（n=47） and unilateral arthroplasty group（n=71）. Variables reflecting safety, economy and effects were set up and data were collected and analyzed. RESULTS AND CONCLUSION： There was no evident difference in safety between simultaneous bilateral arthroplasty and unilateral arthroplasty groups（P〉0.05）. In economy and effect, simultaneous bilateral arthroplasty group was significantly better than unilateral arthroplasty group（P〈0.05）. These results suggest that with the same surgical management level, if the patient could resist, simultaneous bilateral surgery should be more welcomed, while performing simultaneous bilateral surgery in patients with preoperative cardiovascular diseases should be decided carefully. Patients with diabetes mellitus preoperatively should be guarded against postoperative infection.
出处
《中国组织工程研究》
CAS
北大核心
2016年第13期1829-1837,共9页
Chinese Journal of Tissue Engineering Research
