同期双侧全髋关节置换术临床观察.docVIP

同期双侧全髋关节置换术临床观察 　 作者：王培信，庄永，廖春来，秦辉，曾波，谢逸波 【摘要】 目的 探讨同期双侧人工全髋关节置换术的疗效。方法 2000年8月至2005年3月，对10 例(20髋)患者行双侧全髋关节置换术。其中男8 例16髋，女2 例4髋；年龄25～65 岁，病程1～30年(平均4.8年)。术前髋关节Harris评分12～45分，平均27分。其中7 例采用SmithPeterson切口，3 例采用后路Moore切口。手术时间为3.4～5.5 h，平均4.5 h，术中输血600～1 600 mL，平均1 000 mL。结果 10 例均获6个月～5年3个月，平均18个月随访，髋关节术后Harris评分70～100分，平均86分，较术前平均提高59分(27～86分)，差异有统计学意义(P＜0.05)。除1 例患者于术后1个月因心脏病死亡外，其余患者术后均无感染、肺栓塞、深静脉栓塞、假体松动、假体下沉及脱位等并发症发生。患者均能独立行走，自理生活。结论 同期双侧人工全髋关节置换术是一种安全有效的手术，充分的术前准备，慎重选择病例，严格的假体安装标准，有效地风险防范是手术成功的关键。 【关键词】 股骨头缺血坏死；髋关节骨关节炎；双侧；全髋关节置换术 　Clinical Cases Report of Simultaneous Bilateral Total Hip Arthroplasty 　　Abstract： Objective To study the effect of simultaneous bilateral total hip arthroplasty in a sequential procedure. Methods Ten patients(8 man， 2 women； age from 25 to 65 years) were indicated for bilateial total hip arthroplasty (THA) simultaneously from August 2000 to March 2005. Their courses of disease were ranged from 1～30 years(mean years，4.8). Seven cases were done with SmithPeterson incision and three cases were done with Moore incision. The operative time went on 3 hours 25 minutes to 5 hours(mean time， 4 hours 10 minutes). The volume of blood transfusion during operation was 600 to 1 600 mL(mean volume，1 000 mL). They were analyzed with Harris scores of the joint function clinically(hip score of Hospital for Special Surgery). Their preoperative scores were 12 to 45 points(mean score， 27 points). Results All the 10 patients were available for review. With an average of l8 months(range， 6 months to 5 years and 3 months) follow up， Harris scores of the joint function within 70 to 100 points(86 points on average) were significantly improved more than 59 points compared their preoperative scores(P＜0.05). Excepted only one patient died of acute myocardial infarction within the first postoperative month， there were without any severe complications came forth， such as postoperative infection， pulmonary embolism(PE)， and deep venous thrombosis(DVT). All the patien