本文選題：全膝關節(jié)置換　切入點：同期　出處：《蘭州大學》2017年碩士論文

【摘要】：目的:分析比較對于膝關節(jié)OA(osteoarthritis,OA)患者雙側同期和分期行TKA(total knee arthroplasty,TKA)的手術后并發(fā)癥和臨床效果,并探討同期行雙側TKA的安全可行性。方法:收集2014年1月—2016年3月期間在我院接受雙側TKA的70例雙側膝關節(jié)重度骨性關節(jié)炎患者的臨床資料,將其中34例雙側同期行TKA患者納入同期組,其中36例雙側分期行TKA患者納入分期組,分析比較兩組患者的一般資料、術前合并疾病情況、術中術后的出血量及輸血量、手術并發(fā)癥、手術前及手術后一年膝關節(jié)HSS評分及ROM(range of motion,ROM)、住院時間及費用等指標。結果:兩組患者在一般資料、手術前合并癥發(fā)生率以及手術并發(fā)癥發(fā)生率方面差異無統(tǒng)計學意義(P0.05);同期組住院時間短于分期組,結果存在統(tǒng)計學意義(P0.05);分期組住院總費用多于同期組,但出血量及輸血量少于同期組,均存在統(tǒng)計學上意義(P0.05);兩組患者手術前、手術后一年膝關節(jié)HSS評分及ROM相比,均不具有統(tǒng)計學意義(P0.05)。結論:對于雙側膝關節(jié)OA患者,雙側同期與雙側分期TKA具有相同的臨床療效,且不增加手術的風險及并發(fā)癥發(fā)生率,具有縮短患者住院時間、節(jié)省住院花費、減少患者痛苦等多方面優(yōu)勢。對于雙側膝關節(jié)OA患者,全面評估患者基本狀況,在基本狀況相對較好的條件下,可以雙側同期行TKA。
[Abstract]:Objective: to compare the postoperative complications and clinical results of bilateral TKA(total knee arthroplasty in patients with osteoarthritis of knee, and to explore the safety and feasibility of bilateral TKA at the same time.Methods: the clinical data of 70 patients with bilateral severe osteoarthritis of knee joint who received bilateral TKA in our hospital from January 2014 to March 2016 were collected, and 34 cases of bilateral TKA were included in the same group.Thirty-six patients with bilateral TKA were included in the staging group. The general data of the two groups were analyzed and compared, including the preoperative complicated disease, the amount of blood lost during and after operation, the amount of blood transfusion, the complications of the operation.HSS score, ROM(range of motion rom, hospitalization time and cost were measured before and one year after operation.Results: there was no significant difference in general data, incidence of complications and complications between the two groups (P 0.05), and the hospitalization time of the two groups was shorter than that of the staging group.There was no statistical significance of P0.05.Conclusion: for patients with bilateral knee osteoarthritis, bilateral simultaneous and bilateral staging TKA has the same clinical efficacy, and does not increase the risk of surgery and the incidence of complications, it can shorten the hospitalization time of patients and save the cost of hospitalization.Reduce patient suffering and other advantages.For patients with bilateral knee osteoarthritis, the basic condition of the patients was comprehensively evaluated, and TKA could be performed at the same time under the condition of relatively good basic condition.
【學位授予單位】：蘭州大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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