【摘要】：目的比較腓骨近端截骨術與人工全膝關節(jié)置換術(total knee replacement,TKA)治療內(nèi)翻型膝關節(jié)骨關節(jié)炎的短期療效。方法回顧性分析2015年4月至2015年7月內(nèi)蒙古自治區(qū)赤峰市醫(yī)院骨科接受腓骨近端截骨術與TKA治療的內(nèi)翻型膝關節(jié)骨關節(jié)炎患者共103例,符合納入及排除標準的共85例。根據(jù)接受的術式不同分為腓骨截骨組和TKA組。腓骨截骨組患者40例,男11例(27.5%),女29例(72.5%),年齡48~78歲,平均(65.4±8.6)歲;TKA組患者45例,男14例(31.1%),女31例(68.9%),年齡52~81歲,平均(64.3±7.6)歲。分別于術前、術后7d、1個月、2個月、3個月隨訪并比較兩組患者手術前后疼痛視覺模擬評分(visual analogue scale,VAS)、美國特種外科醫(yī)院(hospital for special surgery,HSS)膝關節(jié)評分、血紅蛋白、總失血量、輸血量、手術時間、住院時間、住院期間總花費及觀察術后并發(fā)癥情況。結果 85例患者獲得滿意隨訪,隨訪時間3~5個月。與TKA組患者相比,腓骨截骨組患者的總出血量、輸血量、手術時間、住院時間、總花費較少(P0.05);與術前相比,術后兩組患者的HSS評分均明顯升高、VAS評分均顯著降低(P0.05),VAS和HSS評分的組間比較差異無統(tǒng)計學意義(P0.05);術后TKA組患者的血紅蛋白含量明顯降低(P0.05),腓骨截骨組患者的血紅蛋白含量無顯著變化(P0.05)。結論腓骨近端截骨術可獲得與TKA相似的近期療效,且具有創(chuàng)傷小、失血少、花費低、手術及住院時間短等優(yōu)點,值得臨床推廣。
[Abstract]:Objective to compare the short-term efficacy of fibula proximal osteotomy and total knee arthroplasty (total knee replacement,TKA) in the treatment of varus knee osteoarthritis. Methods from April 2015 to July 2015, 103 patients with varus knee osteoarthritis treated with fibula proximal osteotomy and TKA were analyzed retrospectively, and 85 patients met the criteria of inclusion and exclusion. The fibula osteotomy group and the TKA group were divided into two groups according to the different operative methods. There were 40 patients in fibula osteotomy group, 11 males (27.5%) and 29 females (72.5%). The average age of TKA group was (65.4 鹵8.6) years old, with a mean age of (65.4 鹵8.6) years. There were 14 males (31.1%) and 31 females (68.9%), with a mean age of (64.3 鹵7.6) years. The patients were followed up 7 days, 1 month, 2 months and 3 months before and after operation respectively. The pain visual analogue score (visual analogue scale,VAS), the knee joint score (hospital for special surgery,HSS), hemoglobin, total blood loss, blood transfusion volume were compared between the two groups before and after operation. Operation time, total cost during hospitalization and postoperative complications were observed. Results 85 patients were followed up satisfactorily for 3 ~ 5 months. Compared with the TKA group, the total blood loss, blood transfusion, operation time, hospital stay in the fibula osteotomy group were less than those in the fibular osteotomy group (P0.05). The HSS scores of the two groups were significantly increased after operation (P0.05). There was no significant difference between the VAS and HSS scores (P0.05), the hemoglobin content in the TKA group was significantly lower (P0.05), and the blood red in the fibula osteotomy group was significantly lower than that in the fibula osteotomy group (P0.05). There was no significant change in protein content (P0.05). Conclusion the proximal fibula osteotomy is similar to TKA and has the advantages of less trauma, less blood loss, low cost, short operation and hospital stay, etc. It is worthy of clinical promotion.
【作者單位】： 內(nèi)蒙古自治區(qū)赤峰市醫(yī)院骨關節(jié)科;華中科技大學同濟醫(yī)學院附屬協(xié)和醫(yī)院骨科;
【基金】：國家自然科學基金青年基金項目(30901523)
【分類號】：R687.4

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