一期与分期双膝关节置换术围手术期风险的比较研究

摘要

Objective To compare the rates of perioperative complications in matched patients undergoing simultaneous bilateral total knee arthroplasty,or staged bilateral total knee arthroplasty.Methods A total of 219 cases of bilateral total knee arthroplasty were performed from October 1996 to October 2006.It consisted 171 simultaneous and 48 staged(group B)bilateral total knee arthroplasty.Forty-eight patients were matched with group B for age and sex from simultaneous group(group A).A retrospective review of each group was conducted to compare the rates of perioperative complications.Results No significant differences between the two matched groups were found with regard to preoperative co-morbiditics(P＞0.05).The percentage of patients who had cardiovascular and cerebrovascular complications was significantly higher in the simultaneous group than in the staged group(P＜0.05).Conclusions Preoperative health status must be assessed carefully.Patients must be fully informed of the risks of simultaneous bilateral total knee arthroplasty before surgery.Active prevention of perioperative complications must be applied after surgery.%目的 比较一期双膝关节置换术与分期双膝关节置换术的围手术期并发症的发生率,评价一期双膝关节置换术的安全性.方法 回顾性分析1996年10月至2006年10月接受双膝初次全膝关节置换术的219例患者的临床资料,其中一期双膝关节置换术171例,分期双膝关节置换术48例(B组),按B组年龄性别构成从前者171例患者中1:1匹配抽取48例为A组,与B组进行比较.比较两组术前全身合并症和术后围手术期并发症(B组统计两次手术的累加值)发生情况.结果 匹配后A组和B组的术前全身合并症情况比较差异无统计学意义(P＞0.05),但围手术期A组的心脑血管并发症的发生率较B组增高,差异具有统计学意义(P＜0.05).结论 一期双膝关节置换术前应仔细评估术前全身状况,充分说明手术风险,并积极预防围手术期并发症的发生.