肥胖患者全膝关节置换术后早期并发症分析-外科学专业论文.docxVIP

— — PAGE 1— 摘 要 肥胖患者全膝关节置换术后早期并发症分析 研究生：艾力·热黑 导师：曹力 副教授 摘 要 目的：分析肥胖患者全膝关节置换术（Total Knee Arthroplasty TKA）术后早期 并发症的原因及治疗。方法：对 2002 年 6 月～2008 年 12 月间在我院关节外科治疗 的 257 例（347 膝）TKA 患者进行回顾性分析。按体重指数分为 2 组即对照组(BMI ＜27.0) 和研究组(BMI＞27.0).分别记录术前、术后膝关节评分、功能评分、手术时 间、手术切口长度、早期并发症等。两组病例男 74 例，女 183 例；年龄 22-83 岁， 平均 62.8 岁；身高 147.0-177.0cm，平均 161.0cm，体重 45.0kg-128.0kg,平均 73.1kg. 双膝置换 90 例（180 膝），单膝置换 167 例；左膝 48 膝，右膝 119 膝。均采用进口 膝关节假体。结果：9 膝发生术后早期并发症，发生率为 8.0%。术后早期并发症包 括早期深部感染 1 膝，浅部感染 1 例，脂肪液化 7 膝。结论：肥胖患者 TKA 术后早 期并发症的发生在于患者 BMI 指数大，围手术期并发症增多，包括伤口愈合、感染， 内、外侧副韧带损伤等，这与患肢术前软组织条件差，患者全身情况较差等情况相 关。但肥胖并不是膝关节置换手术的禁忌症，应注意围手术期患者一般情况的持续 观察及术中伤口缝合技术和保护内侧副韧带。合理使用抗凝药物及正确进行术后康 复训练对预防静脉血栓和获得满意的膝关节功能十分重要。 关键词： 肥胖；全膝关节置换术；术后早期并发症 新疆医科大学医学硕士学位论文 Analysis of the early complication by body mass index (BMI) after total knee arthroplasty (TKA). Postgraduate: AiLi·ReHei Adviser: Cao Li Associate Professor Abstract Objective: Investigable study was conducted to analyze the early complication and therpy by body mass index (BMI) after total knee arthroplasty (TKA). Methods: 257 patients wth 347 knees underwant primary TKA. 74 Male,183 female.Year 22-83,average 62.8years.Height 147.0cm–177cm,average 161.0 cm.Body mass 45.0kg-128.0kg, average 73.1kg .Both knee 90 cases(180knees), solo TKA 167 cases,left side 48 knees ,right side 119 cases . All the operations were divided into two groups based on obesity(study group, BMI ＞ 27.0;contral group BMI ＜ 27.0 ).Their baseline knee score and range of motion(ROM) and complications were recorded. Result: 9 knees complication were recorded. The insidecence was 8.0%. The early complications after TKA contain deeply infectipon 1 knee; superficial infectipon 1 knee; fat liquefactipon 7 knees. Conclusion： The BMI has no adverse influence on the short-term outcome of TKA, but is associated with an increase rate of perioperative complications, including poor wound-healing, infection, and avulsion of the medial ligament.Improvement of the operative technique