【摘要】：背景:成人雙側(cè)高位DDH(Hartofilakidis III型)同期與分期行人工全髖關(guān)節(jié)置換術(shù)療效的比較性研究不多。目的:通過對比成人雙側(cè)高位DDH(Hartofilakidis III型)同期、分期行THA術(shù)圍手術(shù)期安全性及相關(guān)臨床指標(biāo),從而實(shí)行最佳治療方案,以此把并發(fā)癥比例最小化,達(dá)到更滿意臨床療效。方法:2004年9月-2015年7月在我院施行雙側(cè)人工全髖關(guān)節(jié)置換術(shù)的57例雙側(cè)高位發(fā)育性髖關(guān)節(jié)脫位(Hartofilakidis III型)的成人病人分為同期組(26例)和分期組(31例)。兩組分別行同期及分期手術(shù)。對比兩組總出、輸血量、總住院時間、手術(shù)前后Harris評分和術(shù)中、術(shù)后并發(fā)癥發(fā)生情況。結(jié)果:57例患者(114髖)均獲得臨床隨訪,圍手術(shù)期共出現(xiàn)17例并發(fā)癥。兩組性別、年齡、總出血量、總并發(fā)癥發(fā)生率、術(shù)前、術(shù)后Harris評分無統(tǒng)計(jì)學(xué)差異,同期組合和分期組均無死亡病人,同期組總輸血率高于分期組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),總住院時間低于分期組差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:同期組總并發(fā)癥發(fā)生率高于分期組,但無統(tǒng)計(jì)學(xué)差異,成人雙側(cè)高位DDH施行THA同期與分期安全性無區(qū)別,且具有住院時間短等優(yōu)點(diǎn),醫(yī)生可于術(shù)前仔細(xì)評估患者全身狀況,依據(jù)患者具體情況選擇手術(shù)方案,同時防止出現(xiàn)圍手術(shù)期并發(fā)癥。
[Abstract]:Background: there are few comparative studies on the efficacy of artificial total hip arthroplasty in adults with bilateral high DDH (Hartofilakidis III. Objective: to compare the perioperative safety and related clinical indexes of bilateral high DDH (Hartofilakidis III in adults by staging THA in order to minimize the incidence of complications and to achieve a more satisfactory clinical effect. Methods: from September 2004 to July 2015, 57 adult patients undergoing bilateral total hip replacement (Hartofilakidis III) were divided into two groups: the same group (n = 26) and staging group (n = 31). The two groups were operated at the same time and by stages. Total output, blood transfusion, total hospital stay, Harris score before and after operation, intraoperative and postoperative complications were compared between the two groups. Results: all the 57 patients (114 hips) were followed up and 17 cases of complications occurred in perioperative period. There was no significant difference in sex, age, total bleeding volume, total complication rate, Harris score before and after operation between the two groups. There were no dead patients in the combination group and staging group, and the total blood transfusion rate in the same period group was higher than that in the staging group. The difference was statistically significant (P0.05), and the total hospitalization time was lower than that of staging group (P0.05). Conclusion: the incidence of total complications in the same period group is higher than that in the staging group, but there is no statistical difference between the two groups. There is no difference in the safety between the simultaneous and staging of bilateral high DDH in adults, and it has the advantages of short hospital stay and so on. The doctor can evaluate the patient's whole body condition carefully before operation, choose the operation plan according to the patient's specific condition, and prevent the perioperative complication at the same time.
【學(xué)位授予單位】：新疆醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R687.4

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