[1]王玉贵 郝阳泉△ 许珂 刘杰 许兆辰 祁翰登.同一住院周期同时与分次双侧全膝关节置换的对比研究[J].中国中医骨伤科杂志,2017,25(04):22-25，30.
　WANG Yugui HAO Yangquan XU Ke LIU Jie XU Zhaochen QI Handeng.Comparative Study of One-stage versus Two-stage Bilateral Total Knee Arthroplasty in the Same Period of Hospitalization[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2017,25(04):22-25，30.
点击复制

同一住院周期同时与分次双侧全膝关节置换的对比研究()
分享到：

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第25卷
期数:
2017年04期
页码:
22-25，30
栏目:
临床研究
出版日期:
2017-04-06

文章信息/Info

Title:
Comparative Study of One-stage versus Two-stage Bilateral Total Knee Arthroplasty in the Same Period of Hospitalization
文章编号:
1005-0205(2017)04-0022-04
作者:
王玉贵1 郝阳泉1△ 许珂2 刘杰1 许兆辰1 祁翰登1
1.陕西中医药大学(陕西 咸阳,712046)
2.西安市红会医院
△.通信作者 E-mail:782041014@qq.com
Author(s):
WANG Yugui1 HAO Yangquan1△ XU Ke2 LIU Jie1 XU Zhaochen1 QI Handeng1
1.Shanxi University of Chinese Medicine,Xianyang 712046,China;
2.Xi'an Honghui Hospital,Xi'an 710054,China.
关键词:
全膝关节置换;  一期双侧;  同时手术;  分次手术
Keywords:
total knee arthroplasty;  simultaneous bilateral;  simultaneous operation;  two-step procedures
分类号:
R687.4
文献标志码:
A
摘要:
目的:探讨同一住院周期内进行同时双侧全膝关节置换(TKA)和分次双侧TKA的临床差异。方法:回顾性分析2015年3月至2016年3月因原发性双膝骨性关节炎在本院一个住院周期内行双侧TKA且随访6个月以上的128例患者的临床资料,根据手术的时间不同分为一期分次双侧TKA组和一期同时双侧TKA组。比较两组患者术前基本情况(年龄、体质量指数(BMI)、术前合并症和假体种类); 围手术期情况(手术风险评分(NNIS)、总失血量、输血量、总手术时间、住院时间)及术后疗效(美国特种外科医院(HSS)膝关节评分、视觉模拟评分(VAS)、术后并发症发生情况。结果:两组患者性别构成、BMI的差异无统计学意义(P>0.05),但一期分次双侧TKA组年龄较大、术前合并症较多; 术后两组患者VAS评分、HSS评分的差异均无统计学意义; 一期同时双侧TKA组虽然住院时间短,但NNIS评分、总失血量、输血量及术后并发症发生率明显高于一期分次双侧TKA组,差异有统计学意义(P<0.05)。结论:对于年龄较大、术前合并症较多的双膝骨性关节炎患者,一期分次双侧TKA仍是不错的选择。
Abstract:
Objective:To explore the clinical effect of one-stage versus two-stage bilateral total knee arthroplasty in the same period of hospitalization.Methods:Followed up for more than 6 months,the clinical data of 128 patients with primary knee osteoarthritis were retrospectively analyzed,who were performed bilateral TKA in our hospital from March 2015 to March 2016 in one period of hospitalization.The patients were divided into one-stage bilateral TKA group and two-stage bilateral TKA group according to the operation time.The basic situation of the two groups(age,body mass index,preoperative complications and prosthesis type),perioperative conditions(NNIS,total blood loss,blood transfusion,total operative time and hospitalization time)and postoperative outcomes(HSS knee score,VAS,postoperative complications)were compared between the two groups.Results:There was no significant difference between the two groups in gender composition,BMI,but the patients in two-stage bilateral TKA group were older and had more preoperative complications.There was no significant difference in VAS score and HSS score between the two groups after operation.Although the hospitalization time was shorter in one-stage group,but the NNIS score,total blood loss,blood transfusion and postoperative complications were significantly higher than that of two-stage group.Conclusion:For the patients with knee osteoarthritis,who is older and with more complications,two-stage bilateral TKA in the same period of hospitalization is a good choice

参考文献/References:

[1] Leonard L,Williamson DM,Ivory JP,et al.An evaluation of the safety and efficacy of simultaneous bilateral total knee arthroplasty[J].J Arthroplasty,2003,18(8):972-978.
[2] Altman R,Alarcon G,Appelrouth D,et al.The American College of Rheumatology criteria for the classification and reporting of osteoarthritis of the hip[J].Arthritis Rheum,1991,34(5):505-514.
[3] Suleiman LI Edelstein AI,Thompson RM,et al.Perioperative outcomes following unilateral versus bilateral total knee arthroplasty[J].J Arthroplasty,2015,30(11):1927-1930.
[4] 孟志超,文立成,曹永平,等.同期双膝关节置换与单膝关节置换的围手术期安全性比较[J].中华骨与关节外科杂志,2016,8(4):322-325.
[5] Kilic E,Sinici E,Tunay V,et al.Evaluation of quality of life of female patients after bilateral total knee arthroplasty[J].Acta Orthop Traumatol Turc,2009,43(3):248-253.
[6] Chen AF,Rasouli MR,Vegari DN,et al.Staged bilateral total knee arthroplasty:time of the second side [J].J Knee Surg,2015,28(4):311-314.
[7] Morrey BF,Adams RA,Ilstrup DM,et a1.Complications and mortality associated with bilateral or unilateral total knee arthroplasty [J].J Bone Joint Surg Am,1987,69(4):484-488.
[8] Odum SM,Troyer JL,Kelly MP,et al.A cost-utility analysis comparing the cost-effectiveness of simultaneous and staged bilateral total knee arthroplasty[J].JBone Joint Surg Am,2013,95(16):1441-1419.
[9] Reuben JD,Meyers SJ,Cox DD,et a1.Cost comparison between bilateral simultaneous,staged and unilateral total joint arthroplasty [J].J Arthroplasty,1998,13(2):172-179.
[10] Macario A,Schilling P,Rubio R,et al.Economics of one-stage versus two-stage bilateral total knee arthroplasties[J].Clin Orthop Relat Res,2003(414):149-156.
[11] Lin AC,Chao E,Yang CM,et al.Costs of staged versus simultaneous bilateral total knee arthroplasty:a population-based study of the Taiwanese National Health Insurance Database [J].J Orthop Surg Res,2014,9:59.
[12] Eroglu M,Er MS,Altinel L,et al.The efficacy of subcutaneous local analgesic infusion in the early postoperative period after bilateral total knee arthroplasty [J].Eklem Hastalik Cerrahisi,2015,26(3):158-163.
[13] Ritter MA,Harty LD.Debate:simultaneous bilateral knee replacements:the outcomes justify its use [J].Clin Orthop Relat Res,2004,428:84-86.
[14] Hooper GJ,Hooper NM,Rothwell AG,et al.Bilateral total joint arthroplasty:the early results from the New Zealand Nation Joint Registry[J].Arthroplasty,2009,24(8):1174-1177.
[15] Yeager AM,Ruel AV,Westrich GH.Are bilateral total joint arthroplasty patients at a higher risk of developing pulmonary embolism following total hip and knee surgery[J]? J Arthroplasty,2014,29(5):900-902.
[16] Lombardi AV,Mallory TH,Fada RA,et al.Simultaneous bilateral total knee arthroplasties:who decides?[J].Clin Orthop Relat Res,2001,392:319-329.
[17] 李祖涛,王利,徐万龙,等.不同手术方案行双侧膝关节置换术的疗效对比[J].中华关节外科杂志:电子版,2015,9(2):174-177.
[18] Parvizi J,Chaudhry S,Rasouli MR,et a1.Who needs autologous blood donation in joint replacement[J]?J Knee Surg,2011,24(1):25-31.
[19] Bierbaum BE,Caltaghan JJ,Galante JO,et a1.An analysis of blood management in patients having a total hip or knee arthroplasty[J].J Bone Joint Surg Am,1999,81(1):2-10.
[20] Pulido L,Ghanem E,Joshi A,et a1.Periprosthetic joint infection:the incidence,timing,and predisposing factors[J].Clin Orthop Relat Res,2008,466(7):1710-1715.

备注/Memo

备注/Memo:
基金项目:陕西省重点科技创新团队项目(2013KCT-26)
更新日期/Last Update: 2017-04-07