Chinese Journal of Tissue Engineering Research ›› 2023, Vol. 27 ›› Issue (4): 565-571.doi: 10.12307/2022.792
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Gu Mingxi, Wang Bo, Tian Fengde, An Ning, Hao Ruihu, Wang Changcheng, Guo Lin
Received:
2021-11-25
Accepted:
2021-12-31
Online:
2023-02-08
Published:
2022-06-22
Contact:
Guo Lin, MD, Chief physician, Professor, Master’s supervisor, Second Department of Orthopedics, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
About author:
Gu Mingxi, Master candidate, Second Department of Orthopedics, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
CLC Number:
Gu Mingxi, Wang Bo, Tian Fengde, An Ning, Hao Ruihu, Wang Changcheng, Guo Lin. Comparison of early efficacy and safety of simultaneous and staged bilateral total knee arthroplasty[J]. Chinese Journal of Tissue Engineering Research, 2023, 27(4): 565-571.
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2.4 两组患者住院时间及住院费用比较 分期组的住院时间是2次单独住院累积的结果,与分期全膝关节置换相比,同期全膝关节置换将住院时间缩短了近50%(P=0.000),且成本降低约20%(P=0.000),见表3。 2.5 两组患者围术期疼痛程度比较 相较于分期组,同期组患者围术期内的疼痛程度更高,见表3。 2.6 两组患者围术期血红蛋白水平和输血量的比较 两组患者术前平均血红蛋白水平差异无显著性意义(P=0.206),见表2。与分期组相比,同期组患者围术期内血红蛋白水平显著降低(P=0.000),平均输血量也更高(P=0.000),表明同期组患者术后用血需求更大,见表3, 2.7 两组患者围术期营养状况的比较 用白蛋白比较了同期组与分期组患者术后的营养状况,同期组围术期内出现低白蛋白血症的风险更高(P=0.028),见表3。 2.8 两组患者围术期并发症的比较 同期组和分期组分别有13例和14例发生贫血、尿路感染、伤口延迟愈合等轻微并发症,通过口服抗生素、放置导尿管、膀胱冲洗及关节穿刺等对症治疗后痊愈,未见其他并发症。两组之间并发症发生差异无显著性意义,见表3。 2.9 两组患者早期临床功能结局的比较 两组患者之间术前与术后膝关节活动度、HSS评分及WOMAC指数的差异无显著性意义(P > 0.05);术后1年随访时,两组术后平均膝关节活动度显著改善,HSS评分也显著改善,WOMAC指数评分明显降低。两组患者术后Feller评分的差异无显著性意义,表明两组患者髌骨关节功能无明显差异(P=0.425),见表4。"
2.10 两组患者早期生活质量的比较 结果显示两组在术后早期随访时生理评分的差异无显著性意义(P=0.073);术后6个月随访时,相较于分期组,同期组患者的心理评分更高(P=0.000),人工关节被遗忘指数(FJS)评分更高,表明选择同期双侧置换的患者能够获得更好本体感觉,见表4。 2.11 生物相容性 两组患者术后均未发生严重不良过敏反应,未出现不明原因的皮肤红斑、湿疹等过敏反应。少数患者术后半年内出现膝关节局部发热反应,部分患者表现出滑膜炎的症状,在排除其他反应热源以后,考虑为金属吸收热,两组之间的局部反应热发生率无明显差异(P > 0.05),经局部激素注射和改善循环治疗后,症状好转,术后1年金属反应热基本消失。 2.12 典型病例图片 同期双侧全膝关节置换前后X射线片见图2;分期双侧全膝关节置换前后X射线见图3。"
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