本文選題：人工關節(jié)置換術 + 月經周期　； 參考：《中國人民解放軍醫(yī)學院》2017年碩士論文

【摘要】：全髖關節(jié)置換術是處理髖關節(jié)終末期疾病最行之有效的解決方案之一,可很大程度上提高髖關節(jié)功能,改善步態(tài),緩解疼痛,中遠期療效肯定。近年來,年輕非絕經期女性罹患終末期髖部疾病數(shù)量逐年增多,隨著人們經濟水平提高、社會觀念改變、醫(yī)學領域的進步以及假體設計理念的更新,越來越多的年輕女性選擇行人工全髖關節(jié)置換術來徹底解決疼痛,糾正步態(tài)及恢復髖部功能,以適應更好的工作崗位和社會地位。月經周期是非絕經期女性特有的生理周期變化,隨著月經周期的變化,婦女體內激素水平同樣呈周期性變化,既往傳統(tǒng)觀念認為經期婦女凝血機制異常,易產生過多的出血,而出血過多引起的貧血、低血壓、凝血障礙、感染等并發(fā)癥風險讓術者擔憂。目的分析婦女不同月經周期階段行人工全髖關節(jié)置換術對術中出血及總出血量的影響。方法回顧分析2010年8月-2017年2月于我院診斷為股骨頭壞死,髖關節(jié)骨性關節(jié)炎,先天性髖臼發(fā)育不良伴脫位(Crowe Ⅰ-Ⅱ型)行單側人工全髖關節(jié)置換術的非絕經期女性250例,年齡19-40 (31.28±5. 72)歲,依患者月經周期,將患者分為月經期組(n=36)、卵泡期組(n=129)、排卵期組(n=51)和黃體期組(n=34)。比較四組患者術中出血及總出血量的差異。結果術中出血量卵泡期組為(318. 60±186. 25 ) ml, 排卵期組為(296. 67±230. 45 ) ml,黃體期組為(341.18±260. 67) ml,月經期組為(297. 22±187.44) ml,四組之間差異無統(tǒng)計學意義(P=0.743)�？偝鲅柯雅萜诮M為(843. 40±514. 98) ml,排卵期組為(741.71 ±420. 83 ) ml,黃體期組為(898. 44±422. 68 ) ml,月經期組為(760. 53±360. 27) ml,四組之間差異同樣無統(tǒng)計學意義(P = 0.347)。結論月經期為患者行人工全髖關節(jié)置換術,對術中出血及總出血量的影響不顯著。
[Abstract]:Total hip replacement is one of the most effective solutions for the treatment of end-stage hip diseases. It can greatly improve hip function, improve gait and relieve pain. In recent years, the number of young and non-menopausal women suffering from end-stage hip diseases has increased year by year, as people's economic level has improved, social attitudes have changed, the medical field has advanced and the concept of prosthetic design has been updated. More and more young women choose artificial total hip replacement to completely solve the pain, correct gait and restore hip function in order to adapt to better job and social status. The menstrual cycle is unique to women in the non-menopausal period. With the change of menstrual cycle, the hormone level in women's body also changes periodically. The traditional view is that the coagulation mechanism of women in menstrual period is abnormal, and it is easy to cause excessive bleeding. The risk of complications such as anaemia, hypotension, clotting disorder, and infection caused by excessive bleeding is a concern to the operator. Objective to analyze the effect of artificial total hip arthroplasty (THR) on intraoperative bleeding and total bleeding in women with different menstrual cycles. Methods from August 2010 to February 2017, 250 non-menopausal women who were diagnosed as osteonecrosis of femoral head, osteoarthritis of hip, congenital acetabular dysplasia with dislocation of Crowe 鈪，

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