同期与分期双侧全髋关节置换术短期临床疗效的比较

摘要

目的：比较同期与分期双侧全髋关节置换术对短期临床疗效的影响。方法选取2013年2月至2014年3月在临朐县人民医院诊治的双侧全髋关节置换术患者48例（96个关节），按照随机数字表法分为同期组（24例）和分期组（24例）。同期组进行同期双侧全髋关节置换术，分期组给予分期双侧全髋关节置换术。比较两组患者的手术时间、总出血量、总输血量、总住院时间、总住院费用以及Harris评分和手术后并发症发生情况。结果两组患者的手术时间、总出血量、总输血量以及Harris评分比较差异无统计学意义（ P＞0．05）。同期组总住院时间、总住院费用均少于分期组，差异有统计学意义（P＜0．01）。同期组总并发症发生率高于分期组（37．5％比8．3％），差异有统计学意义（χ2＝4．45，P＜0．05）。结论行同期双侧全髋关节置换术较行分期双侧全髋关节置换术具有住院时间短、住院费用低、术后恢复快等优点，而分期双侧全髋关节置换术具有较低的并发症发生率，应视患者的病情及经济情况合理应用。%Objective To compare the impact of bilateral total hip arthroplasty by simultaneous or staged procedures on the short-term clinical efficacy .Methods A total of 48 cases ( 96 joints ) receiving bilateral total hip arthroplasty admitted to Linquxian People′s Hospital from Feb.2013 to Mar.2014 were included and divided into two groups:simultaneous group(24 cases) and staged group (24 cases) according to random number table method.Simultaneous group received simultaneous bilateral total hip arthroplasty , while staging group received staged bilateral total hip arthroplasty.The operation time,total amount of bleed-ing,blood transfusion,the total length of stay,total hospital costs,the Harris scores,and perioperative compli-cations(infection,pulmonary embolism,deep venous thrombosis,prosthesis loosening and dislocation,and two leg length discrepancy) were compared.Results The operation time,the total amount of bleeding,total amount of transfustion and the Harris scores were not statistically significantly different ( P >0.05 ) .Total hospitalization time,total hospital costs of the simultaneous group were lower than the staged group ,the differ-ence was statistically significant ( P <0.01 ) .Total complication rate of the simultaneous group was higher than staged group(37.5% vs 8.3%),the difference was statistically significant(χ2 =4.45,P <0.05). Conclusion The simultaneous bilateral total hip arthroplasty has the advantages of shorter hospital stay ,fas-ter recovery after surgery,while the staged bilateral total hip arthroplasty has the advantage of low complica-tion rate.A rational approach should be chosen depending on the patient′s illness and economic condition.