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-东南大学学报医学版

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

单位：中国医科大学附属盛京医院骨科, 辽宁沈阳 110003

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.

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