同期双侧全髋关节置换术临床观察.doc

同期双侧全髓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髓关节置换术的疗效。方法2000年8月至2005年3月,对10例(20髓)患者行双侧全髓关节置换术。其中男8例16髓,女2例4髓;年龄25〜65岁,病程1〜30年()。术前髓关节Harris评分12〜45分,平均27分。其中7例采用SmithPeterson切口,3例采用后路Moore切口。〜,,术中输血600-1600mL,平均1000mL。结果10例均获6个月〜5年3个月,平均18个月随访,髓关节术后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<)o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髓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;髓关节骨关节炎;双侧;全髓关节置换术ClinicalCasesReportofSimultaneousBilateralTotalHipArthroplastyAbstract:(8man,2women;agefrom25to65years)wereindicatedforbilateialtotalhiparthroplasty(THA)〜30years(meanyears,).(meantime,4hours10minutes).Thevolumeofbloodtransfusionduringoperationwas600to1600mL(meanvolume,1000mL).TheywereanalyzedwithHarrisscoresofthejointfunctionclinically(hipscoreofHospitalforSpecialSurgery).Theirpreoperativescoreswere12to45points(meanscore, 27points).(range,6monthsto5yearsand3months)followup,Harrisscoresofthejointfunctionwithin70to100points(86pointsonaverage)paredtheirpreoperativescores(P<).Exceptedonlyonepatientdiedofacutemyocardialinfarctionwithinthefirstpostoperativemonth,plicationscameforth,suchaspostoperativeinfection,pulmonaryembolism(PE),anddeepvenousthrombosis(DVT).,:osteonecrosisoffemoralhead;hiposteoarthritis;bilateral;totalhiparthroplas