全膝关节置换术后早期并发症的原因分析

Analysis of the causes of early complications after total knee arthroplasty

目的报告89例全膝关节表面置换术治疗骨关节病及类风湿性关节炎的疗效。通过随访2010—2013年的骨关节病及类风湿性关节炎行关节置换手术患者,将手术后出现的早期并发症进行治疗并分析并发症发生的相关危险因素及原因。方法对89例全膝关节置换术的患者进行随访,并用HSS评分系统进行分析;随访6~36个月,平均21个月。记录手术后早期出现深静脉血栓、出现感染的并发症,分析并发症出现的原因。结果本组89例患者中,优52例（58.4%）,良26例（29.2%）,可11例（12.4%）。术后在疼痛、关节功能及活动度上均有明显改善。对疼痛评分、功能改善,手术优良率87.6%。患者术后在疼痛、功能方面都有明显改善,尤其在缓解疼痛方面效果显著。早期并发症发生深静脉血栓7例,肺栓塞患者3例,术后早期出现的深静脉血栓致死率极高。结论全膝关节表面置换术对治疗严重骨关节病及类风湿性关节炎效果满意,但围手术期并发症多发,早期并发症严重影响患者预后,预防深静脉血栓与感染是提高手术成功率的重要手段。

Objective To report 89 cases of total knee arthroplasty, the curative effect of treating osteoarthrosis and rheu- matoid arthritis. Methods 89 cases of patients with total knee arthroplasty were followed up, and the HSS score system was analyzed;they were followed up for 6 -36 months, an average of 21 months. Record a deep vein thrombosis early after surgery and complications of infection, the reasons of complications were analyzed. Results The follow up showed that excellent and good results were achieved in 87.6 %. Patients in the postoperative pain, function had been improved signif- icantly, especially in terms of pain relief effect is remarkable. But early postoperative deep vein thrombosis of the fatality rate was extremely high,infection leading to operation failure rate was higher. Conclusion Total knee replacement pres- ented a satisfactory procedure to serious osteoarthritis of the knee, but with more perioperative complications, prevention of deep vein thrombosis and infection was an important means to improve the success rate of surgery.