同期双侧与单侧全髋关节置换术治疗严重髋部病变的临床比较研究

Comparison between simultaneous bilateral and unilateral total hip arthroplasty in treating severe hip diseases

目的比较同期双侧与单侧全髋关节置换术(THA)的临床疗效和安全性。方法回顾性分析因股骨头缺血性坏死等严重髋部病变行初次THA 786例,其中同期双侧置换125例(SBTHA组),单侧置换661例(UTHA组)。比较两组术前与术后Harris评分、术前合并症、围手术期并发症、失血及输血量、住院时间及费用等方面的差异。结果两组手术前后Harris评分差异均无统计学意义(P>0.05),但SBTHA组泌尿系统并发症及肺栓塞发生率高于UTHA组,差异有统计学意义(P<0.05)。结论对于双髋严重病变的患者,行SBTHA是安全有效的,相对于2次独立的UTHA也较经济、便捷。

Objective To retrospectively compare the efficacy and safety of simultaneous bilateral total hip arthroplasty （SBTHA） and that of unilateral total hip arthroplasty （UTHA） in the treatment of severe hip diseases. Methods The clinical data of 786 patients who underwent primary THA to treat severe hip diseases were analyzed. Of 786 patients, 125 had SBTHA, 661 had UTHA. The two groups were compared according to preoperative and postoperative Hip Harris Scores, preoperative eomorbidities, perioperative complications, blood loss, transfusion requirement, days and cost of hospitalization. Results No significant differences were found with regard to preoperative and postoperative Hip Harris Scores between two groups （P 〉 0.05）. The total rate of perioperative complications was significantly higher in the SBTHA group than in the UTHA group. Specifically, the rates of urinary complications and pulmonary embolism were significantly increased in the SBTHA group （P 〈 0.05）. Conclusion In selected patients with bilateral severe hip diseases, SBTHA is safe, effective, cost-effective, and convenient.