同期与分期双髋关节置换112例围手术期风险的比较

Perioperative risks of simultaneous versus staged bilateral total hip arthroplasty in 112 patients

背景:同期与分期双髋关节置换所引起的围手术期并发症的比较性研究目前存在着争论。目的:比较同期双髋关节置换与分期双髋关节置换的围手术期并发症的发生率,评价同期双髋关节置换术的安全性。方法:回顾性分析接受双髋初次全髋关节置换术的112例患者的临床资料,其中同期双髋关节置换术81例,分期双髋关节置换术31例,以分期组年龄性别构成从同期组81例患者中1∶1匹配抽取31例,与分期组进行比较。比较两组术前全身合并症和术后围手术期并发症(分期组统计两次手术的累加值)发生情况。结果与结论:匹配后同期组和分期组的术前全身合并症情况比较差异无显著性意义(P>0.05);术中出血量比较差异无显著性意义。围手术期同期组的心脑血管并发症的发生率较分期组增高,差异有显著性意义(P<0.05)。结果提示,同期双髋关节置换术前应仔细评估术前全身状况,充分说明手术风险,并积极预防围手术期并发症的发生。

BACKGROUND：Comparison of perioperative complications between simultaneous and staged bilateral total hip arthroplasty remains controversial.OBJECTIVE：To compare the rates of perioperative complications in patients undergoing simultaneous or staged bilateral total hip arthroplasty and evaluate the safety of simultaneous total hip arthroplasty METHODS：A total of 112 cases undergoing primary bilateral total hip arthroplasty were retrospectively analyzed,including 81 of simultaneous and 31 staged bilateral total hip arthroplasty.A total of 31 patients of age and sex matched were selected from simultaneous group to compare with staged group.Rate of perioperative complications of two groups was compared.RESULTS AND CONCLUSION：No significant differences between the two matched groups were detected with regard to preoperative complications（P 0.05）.The percentage of patients who had cardiovascular and cerebrovascular complications was significantly higher in the simultaneous group than in the staged group（P 0.05）.Preoperative health status must be assessed carefully.Patients must be fully informed the risks of simultaneous bilateral total hip arthroplasty before surgery.Active prevention of perioperative complications should be applied after surgery.