本文關鍵詞： 膝關節(jié) 人工 關節(jié)成形術 置換 髖 暫停手術 術前管理 醫(yī)療效率　出處：《北京大學學報(醫(yī)學版)》2017年02期 　論文類型：期刊論文

【摘要】：目的:分析擇期膝、髖關節(jié)置換術前非計劃性暫停手術的現(xiàn)狀和原因,尋找其中的規(guī)律和共同性,為進一步優(yōu)化擇期膝、髖關節(jié)置換的患者術前管理,提高醫(yī)療資源的使用效率提供依據(jù)。方法:選擇北京大學第三醫(yī)院骨科2013年9月至2014年8月住院擬擇期行膝、髖關節(jié)置換手術,但術前因故被暫停手術的病例資料,記錄這些病例被暫停手術的原因,對其進行分析。結果:共擬行膝、髖關節(jié)置換手術1 146臺,其中完成1 003臺,因故暫停143臺,停手術率達12.5%。暫停手術最常見的原因是心血管系統(tǒng)疾病(31%),其他部位感染(14%),菌尿(13%)和手術適應證不強(11%),其他導致手術暫停的原因還有血液系統(tǒng)檢查異常、下肢靜脈血栓、肝功能異常、血糖控制欠佳等。在不同性別的患者之間,停手術率差異無統(tǒng)計學意義(男性15.0%,女性11.6%,P=0.149),不同年齡段的患者之間,停手術率差異無統(tǒng)計學意義(≤50歲13.0%,51~65歲11.6%,66~80歲13.3%,80歲11.1%,P=0.864),但髖關節(jié)置換較膝關節(jié)置換更易被暫停手術(膝關節(jié)置換11.1%,髖關節(jié)置換16.1%,P=0.021)。結論:對于擇期行膝、髖關節(jié)置換的患者進行恰當?shù)男g前教育和管理非常重要,通過明確診斷、細致的病史詢問和體格檢查,以及有針對性的檢查化驗,盡量避免住院后暫停手術的發(fā)生,提高醫(yī)療資源的使用效率。
[Abstract]:Objective: to analyze the present situation and causes of unplanned suspension before elective knee and hip arthroplasty, and to find out the regularity and commonality in order to optimize the preoperative management of patients with selective knee and hip arthroplasty. Methods: from September 2013 to August 2014, the orthopaedic department of the third Hospital of Peking University was selected to perform knee and hip arthroplasty, but the operation was suspended before operation. The causes of the suspension were recorded and analyzed. Results: a total of 1,146 knee and hip replacement operations were performed, of which 1,003 were completed and 143 were suspended. The most common reasons for suspending surgery are cardiovascular diseases (31), infection in other parts (14), bacteriuria (1313) and the lack of indications for surgery. Other reasons leading to the suspension of surgery include abnormal blood system examination and venous thrombosis in the lower extremity. Abnormal liver function, poor blood glucose control and so on. There was no significant difference in the rate of stopping surgery among patients of different gender (male 15.0, female 11.6T 0.149, age group 0.149, male 15.0, female 11.6T 0.149, P < 0.05). There was no significant difference in the rate of discontinuation of operation (鈮，

本文編號：1536599