林景川

[摘要] 目的 研究與分析同期和分期全膝关节置换术对双膝关节骨关节炎的临床疗效与安全性对比情况。 方法 该院采取随机的原则选取来该院进行治疗的患有双膝关节骨关节炎的96例患者（2016年4月—2018年4月），随后根据患者的不同手术方式将患者分为两组，即同期全膝关节置换术组（62例）与分期全膝关节置换术组（34例）。其中同期全膝关节置换术组患者采取同期全膝关节置换术进行治疗，而分期全膝关节置换术组患者则采取分期全膝关节置换术治疗，随后观察两组患者的手术时间、住院时间、住院总费用、累计出血量、累计输血量以及并发症发生情况。结果 同期全膝关节置换术组患者的手术时间、住院时间以及住院总费用等情况[（134.33±12.99）min，（17.38±2.31）d，（71 232±3 926）元]显著优于分期全膝关节置换术组[（164.87±15.48）min，（26.48±4.49）d，（103 944±4 036）元]，差异有统计学意义（t=3.621 2、2.952 1、2.612 0、P<0.05），但是同期全膝关节置换术组患者的累计出血量、累计输血量以及并发症发生情况[（1 129.73±34.38）mL，（934.38±102.38）mL，17.7%]显著高于分期全膝关节置换术组[（976.46±32.06）mL，（802.65±93.28）mL，5.9%]，差异有统计学意义（t=2.942 3、4.054 2、χ2=3.661 2，P<0.05）。 结论 同期全膝关节置换术对双膝关节骨关节炎的手术创伤较大，术后并发症发生率较高，在临床应用时需要谨慎选择。

[关键词] 同期全膝关节置换术;分期全膝关节置换术;双膝关节骨关节炎;安全性

[中图分类号] R687.4          [文献标识码] A          [文章编号] 1674-0742（2018）08（c）-0043-03

Comparison of Clinical Efficacy and Safety of Simultaneous Knee and Knee Joint Osteoarthritis

LIN Jing-chuan

Department of Orthopedics， the First Affiliated Hospital of Fujian Medical University， Quanzhou， Fujian Province， 362803 China

[Abstract] Objective To study and analyze the clinical efficacy and safety of simultaneous knee and knee joint osteoarthritis in the same period and in stages. Methods This hospital took a random selection of 96 patients with osteoarthritis of both knees （from April 2016 to April 2018） to be treated in the hospital. The patients were then divided into two groups according to their different surgical procedures. The group consisted of a total knee arthroplasty group （62 cases） and a staged total knee arthroplasty group （34 cases）. In the same period， the total knee arthroplasty group was treated with simultaneous total knee arthroplasty， while the staged total knee arthroplasty group was treated with staged total knee arthroplasty. The operation time and length of stay， total hospital expenses， accumulated blood loss， cumulative blood transfusions， and complications were then observed. Results The operative time， length of hospital stay， and hospitalization total cost of patients in the total knee arthroplasty group [（134.33±12.99）min， （17.38±2.31）d， （71 232±3 926）yuan] were significantly better than those in the total knee arthroplasty group[（164.87±15.48）min， （26.48±4.49）d， （103 944±4 036）yuan]， the difference was statistically significant （t=3.621 2， 2.952 1， 2.612 0， P<0.05）， but cumulative hemorrhage volume， cumulative blood transfusion volume， the incidence of complications of the total hip arthroplasty group during the same period[（1 129.73±34.38）mL，（934.38±102.38）mL， 17.7%] was significantly higher than that of the staged total knee arthroplasty group [（976.46±32.06）mL， （802.65±93.28）mL，5.9%]， the difference was statistically significant （t= 2.942 3， 4.054 2， χ2=3.661 2， P<0.05）. Conclusion At the same time， total knee arthroplasty has large surgical trauma to the knee joint osteoarthritis， and the incidence of postoperative complications is high. It needs to be carefully selected in clinical application.

[Key words] Synchronous total knee arthroplasty; Staged total knee arthroplasty; Double knee osteoarthritis; Safety

双膝关节骨关节炎是骨科中的最为常见的关节性疾病之一，对于该疾病的治疗一般需要采取手术治疗[1]。该院自2016年4月—2018年4月对来该院进行治疗的患有双膝关节骨关节炎的94例患者采取同期和分期全膝关节置换术治疗，现将结果报道如下。

1  资料与方法

1.1  一般资料

该院采取随机的原则选取来该院进行治疗的患有双膝关节骨关节炎的96例患者，随后根据患者的不同手术方式将患者分为两组，即同期全膝关节置换术组（62例）与分期全膝关节置换术组（34例）。……