同期双侧全髋关节置换术的临床观察

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1、同期双侧全髋关节置换术的临床观察作者：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3.4～5.5h，平均4.5h，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

2、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11　ClinicalCasesReportofSimultaneous

3、BilateralTotalHipArthroplasty　　Abstract：ObjectiveTostudytheeffectofsimultaneousbilateraltotalhiparthroplastyinasequentialprocedure.MethodsTenpatients(8man，2women；agefrom25to65years)wereindicatedforbilateialtotalhiparthroplasty(THA)simultaneouslyfromAugust2000toMarch2005.The

4、ircoursesofdiseasewererangedfrom1～30years(meanyears，4.8).SevencasesweredonewithSmithPetersonincisionandthreecasesweredonewithMooreincision.Theoperativetimewenton3hours25minutesto5hours(meantime，4hours10minutes).Thevolumeofbloodtransfusionduringoperationwas600to1600mL(meanv

5、olume，1000mL).TheywereanalyzedwithHarrisscoresofthejointfunctionclinically(hipscoreofHospitalforSpecialSurgery).Theirpreoperativescoreswere12to45points(meanscore，27points).ResultsAllthe10patientswereavailableforreview.Withanaverageofl8months(range，6monthsto5yearsand3months)

6、followup，Harrisscoresofthejointfunctionwithin70to100points(86pointsonaverage)weresignificantlyimprovedmorethan59pointscomparedtheirpreoperativescores(P＜0.05).Exceptedonlyonepatientdiedof11acutemyocardialinfarctionwithinthefirstpostoperativemonth，therewerewithoutanyseverecom

7、plicationscameforth，suchaspostoperativeinfection，pulmonaryembolism(PE)，anddeepvenousthrombosis(DVT).Allthepatientswerestillambulantinthecommunityandgameddailylivingabilities.ConclusionSimultaneousbilateraltotalhiparthroplastyisasafeandeffectivemethod.However，thedecisionofpe

8、rformingsinglestagebilateraltotalhiparthroplastyshouldbecarefullymadeandpreoperat