大骨节病重度膝关节炎患者全膝关节置换术后生活质量评估

Assessment of quality of life after total knee arthroplasty in patients with severe knee osteoarthritis of Kashin-Beck disease

目的评价大骨节病（KBD）患者接受全膝关节置换术手术前、手术后的生活质量。方法采用前瞻性设计，观察自2015年1月至2017年1月在陕西省人民医院骨科接受全膝关节置换术的25例KBD患者的临床疗效，应用KBD患者生命质量量表（KBDQOL），在术前、术后6个月和术后1年评估患者的生活质量。结果术后6个月和术后1年KBD患者的躯体功能、活动限制、社会支持、精神状况和总的健康得分（30.60 ± 3.73、23.24 ± 2.03、15.16 ± 1.62、18.92 ± 2.89、12.80 ± 2.57，32.00 ± 3.19、23.76 ± 1.59、15.60 ± 1.29、20.16 ± 2.67、17.28 ± 3.88）均显著高于术前（18.84 ± 4.94、21.04 ± 2.72、12.80 ± 2.06、13.68 ± 3.42、7.92 ± 1.93，P均〈 0.05）；术前、术后6个月、术后1年的经济得分（10.68 ± 2.98、10.60 ± 2.78、10.48 ± 2.80）比较差异无统计学意义（P 〉 0.05）。结论KBD重度膝关节炎患者在全膝关节置换术后的生活质量明显优于手术前。KBDQOL是评价KBD患者生活质量的适宜工具。

ObjectiveTo evaluate the quality of life of patients with Kaschin-Beck disease （KBD） receiving total knee arthroplasty （TKA） before and after the operation.MethodsClinical efficacy of 25 patients with KBD who underwent TKA in Department of Orthopaedics, Shaanxi Provincial People＇s Hospital from January 2015 to January 2017 was prospectively analyzed. A questionnaire survey on KBD quality of life （KBDQOL） was carried out to evaluate the quality of life of the patients before, 6 months and 1 year after the surgery.ResultsThe scores of physical function, activity limit, social support, mental status and total health scores of KBDQOL in 6 months after the surgery （30.60 ± 3.73, 23.24 ± 2.03, 15.16 ± 1.62, 18.92 ± 2.89, 12.80 ± 2.57） and 1 year after the surgery （32.00 ± 3.19, 23.76 ± 1.59, 15.60 ± 1.29, 20.16 ± 2.67, 17.28 ± 3.88） were significantly higher than those of before the surgery （18.84 ± 4.94, 21.04 ± 2.72, 12.80 ± 2.06, 13.68 ± 3.42, 7.92 ± 1.93, P 〈 0.05）. However, there was no significant difference in economic scores before, 6 months and 1 year after the surgery （10.68 ± 2.98, 10.60 ± 2.78, 10.48 ± 2.80, P 〉 0.05）.ConclusionsThe quality of life after TKA in patients with KBD severe knee osteoarthritis is significantly better than that before the surgery. The KBDQOL questionnaire is an appropriate tool for evaluating the quality of life in KBD patients.