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1、临床医学论文•同期双侧全競关节置换术的临床观察作者：王培信，庄永，丿寥春来，秦辉，曾波，谢逸波【摘要】目的探讨同期双侧人工全競关节置换术的疗效。方法2000年8月至2005年3丿」，对10例（20髓）患者行双侧全髓关节置换术。其中男8例16瓠，女2例4瓠；年龄25〜65岁,病程1〜30年（平均4.8年）。术前瓠关节Harris评分12〜45分，平均27分。其中7例采用SmithPeterson切口，3例釆用后路Moore切口。手术时间为3.4〜5.5h,平均4.5h,术中输血600〜1600mL,
2、平均1000mLo结果10例均获6个月〜5年3个月，平均18个月随访，競关节术后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（PV0.05）。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骯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；
3、競关节骨关节炎；双侧；全競关节置换术ClinicalCasesReportofSimultaneousBilateralTotalHipArthroplastyAbstract：ObjectiveTostudytheeffectofsimultaneousbilateraltotalhiparthroplastyinasequentialprocedure・MethodsTenpatients(8man,2women；agefrom25to65years)wereindicatedforbilat
4、eialtotalhiparthroplasty(THA)simultaneouslyfromAugust2000toMarch2005.Theircoursesofdiseasewererangedfroml~30years(meanyears,4.8).SevencasesweredonewithSmithPetersonincisionandthreecasesweredonewithMooreincision.Theoperativetimcwenton3hours25minutesto5
5、hours(meantime,4hours10minutes).Thevolumeofbloodtransfusionduringoperationwas600to1600mL(meanvolume,1000mL).TheywereanalyzedwithHarrisscoresofthejointfunctionclinically(hipscoreofHospitalforSpecialSurgery).Theirpreoperativescoreswere12to45points(means
6、core,27points).ResultsAl1the10patientswereavailableforreview.Withanaverageof18months(range,6monthsto5yearsand3months)followup,Harrisscoresofthejointfunctionwithin70to100points(86pointsonaverage)weresignificantlyimprovedmorethan59pointscomparedtheirpre
7、operativescores(P<0.05)・Exceptedonlyonepatientdiedofacutemyocardialinfarctionwithinthefirstpostoperativemonth,therewerewithoutanyseverecomplicationscameforth,suchaspostoperativeinfection,pulmonaryembolism(PE),anddeepvenousthrombosis(DVT).Al1thepatient
8、swerestillambulantinthecommunityandgameddaily1ivingabilities・ConclusionSimultaneousbilateraltotalhiparthroplastyisasafeandeffectivemethod・However,thedecisionofperformingsinglestagebilateraltotalhiparthroplastyshouldbecarefullymadeandpreoperati
