23例丙型肝炎患者全髋关节置换术回顾性分析

Retrospective analysis of 23 cases of hepatitis C patients with total hip arthroplasty

目的回顾性观察及分析丙型肝炎患者全髋关节置换术围手术期相关指标及术后并发症。方法选择2010年-2015年河北医科大学附属华北石油管理局总医院收治的行髋关节置换术的丙肝患者23例,纳入丙肝组;并随机选择同期接受全髋关节置换术的无感染患者35例,纳入对照组。统计两组患者病例资料,收集患者围手术期资料,统计术后近期并发症(药源性和术源性)发生情况。采用SPSS 19.0软件分析对比两组间差异。结果两组患者性别、年龄、Deyo分数、术前Harris评分等基线资料差异无统计学意义,具有可比性。丙肝患者中,11.36%患者是急性感染,47.54%患者是慢性感染,41.10%患者处于潜伏感染状态。丙肝组手术时长明显长于对照组(124.62±37.53)min vs(117.67±41.07)min,P<0.01;丙肝组术中出血量明显大于对照组(619.7±116.8)ml vs(453.2±62.9)ml,P<0.01;丙肝组首次下地时间和住院总时长均明显长于对照组;术后丙肝组Harris评分明显低于对照组(57.69±9.55)分vs(32.21±4.97)分,P<0.01。丙肝组患者关节置换术后并发症发生率明显高于对照组。结论丙肝病毒感染患者的全髋关节置换风险增加,手术并发症发生率增高,术前须告知患者相关风险,术者应仔细慎重操作,术后严密观察,预防并发症。

Objective To retrospectively observe and analyze perioperative and postoperative indicators and complications of patients with hepatitis C underwent total joint arthroplasty. Methods From 2010 to 2015, 23 cases of hepatitis C patients with hip replacement surgery in our hospital were slected as the hepatitis C group, and 35 patients without hepatitis C infection who received hip replacement surgery randomly selected as the control group. The baseline data of two groups, such as the age, gender, the perioperative data, post-operational complications （drugs-induced and operation-induced） were observed and collected. The results and the differences between the two groups were analyzed by SPSS 19.0 software. Results The two groups whad no difference of gender, age, Deyo score and preoperative Harris score. Among the HCV patients, 11.36% had the acute infection, 47.54% patients were chronic infection and others were in latent infection. The operation time of the HCV group was significantly longer than the control group （124.62 ±＋ 37.53） rain vs （117.67 ± 41.07） min, P 〈 0.01. The bleeding amount of HCV group was significantly more than control group （619.7 ±116.8） ml vs （453.20 ± 62.90） ml, P 〈 0.01. The first ambulation time and total in-hospital duration of the HCV group were both significantly longer than the control group. Harris score of the HCV group after operation was significantly lower than the control group （57.69 ± 9.55） vs （32.21± 4.97）, P 〈 0.01. The incidence of complications after joint replacement in patients with hepatitis C was significantly higher than the control group. Conclusions Risk of total hip arthroplasty for Hepatitis C patients is increased, and complications incidence associated with the surgel7 is increased. The related risks shall be infinned to patients, intraoperative operation should be more eareful, and postoperative close observation should he given to prevent complications.