摘要
目的 探讨病毒载量对人类免疫缺陷病毒(HIV)合并股骨头坏死患者行全髋关节置换术(THA)的影响。方法 将50例HIV合并股骨头坏死行THA治疗的患者根据术前病毒载量的不同分为A组(病毒载量<30 000 copy/ml, 35例)和B组(病毒载量≥30 000 copy/ml, 15例)。记录两组手术情况、CD4^(+)T淋巴细胞水平及术后并发症发生情况,采用髋关节功能Harris评分评价疗效。结果 患者均获得36个月随访。手术时间、术中出血量、术后引流量、住院时间两组比较差异均无统计学意义(P>0.05)。两组CD4^(+)T淋巴细胞水平变化在术后2周及1、3、6、12、24、36个月与术前比较差异均无统计学意义(P>0.05),两组术后各时间点比较差异均无统计学意义(P>0.05)。髋关节功能Harris评分两组术后1、3、6、12、24、36个月均较术前改善(P<0.05),两组术后各时间点比较差异均无统计学意义(P>0.05)。术后B组1例(1/15)发生肺部感染,A组3例(3/35)、B组3例(3/15)发生切口周围浅表感染,两组术后并发症发生率比较差异无统计学意义(P>0.05)。结论 高病毒载量对于HIV合并股骨头坏死患者行THA影响较小,但仍建议做好围手术期准备,将病毒载量降至低水平后再行手术治疗。
Objective To investigate the effect of viral load on total hip arthroplasty(THA)in patients with human immunodeficiency virus(HIV)patients complicated with femoral head necrosis.Methods The 50 cases of HIV patients with femoral head necrosis who underwent THA were divided into group A(viral load<30000 copy/ml,35 cases)and group B(viral load≥30000 copy/ml,15 cases),according to the difference of preoperative viral load.Operation situation,CD4^(+)T lymphocyte level and postoperative complications were recorded in the two groups,and Harris score of hip function was used to evaluate the efficacy.Results All patients were followed up for 36 months.There were no significant differences in operation time,intraoperative blood loss,postoperative drainage volume and hospital stay between the two groups(P>0.05).The level of CD4^(+)T lymphocytes:there were no significant differences between two groups at 2 weeks and 1,3,6,12,24 and 36 months after surgery(P>0.05),and there were no significant differences between two groups at each time point after surgery(P>0.05).Harris scores of hip joint function:they were improved at 1,3,6,12,24 and 36 months after surgery,compared with the preoperation(P<0.05),and there were no statistical significances between the two groups at each time point after surgery(P>0.05).Postoperative pulmonary infection occurred in 1 case(1/15)of group B;and the superficial infection around the incision occurred in 3 cases of group A(3/35)and 3 cases(3/15)of group B,there was no significant difference in the incidence rate of postoperative complications between the two groups(P>0.05).Conclusions High viral load has little effect on THA in HIV patients with femoral head necrosis.However,it is still recommended to prepare for the perioperative period and perform surgery after the viral load drops to a low level.
作者
刘俊洪
寸新华
张建洪
陈佳晖
梁一鸣
魏树发
杨毅
李彪
LIU Jun-hong;CUN Xin-hua;ZHANG Jian-hong;CHEN Jia-hui;LIANG Yi-ming;WEI Shu-fa;YANG Yi;LI Biao(Dept of Orthopaedics,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650032,China)
出处
《临床骨科杂志》
2023年第2期187-192,共6页
Journal of Clinical Orthopaedics
基金
云南省骨关节疾病临床医学中心基金资助项目(编号:ZX-2019-03-04)。
