【摘要】：目的比較腓骨近端截骨術(shù)與人工全膝關(guān)節(jié)置換術(shù)(total knee replacement,TKA)治療內(nèi)翻型膝關(guān)節(jié)骨關(guān)節(jié)炎的短期療效。方法回顧性分析2015年4月至2015年7月內(nèi)蒙古自治區(qū)赤峰市醫(yī)院骨科接受腓骨近端截骨術(shù)與TKA治療的內(nèi)翻型膝關(guān)節(jié)骨關(guān)節(jié)炎患者共103例,符合納入及排除標(biāo)準(zhǔn)的共85例。根據(jù)接受的術(shù)式不同分為腓骨截骨組和TKA組。腓骨截骨組患者40例,男11例(27.5%),女29例(72.5%),年齡48~78歲,平均(65.4±8.6)歲;TKA組患者45例,男14例(31.1%),女31例(68.9%),年齡52~81歲,平均(64.3±7.6)歲。分別于術(shù)前、術(shù)后7d、1個(gè)月、2個(gè)月、3個(gè)月隨訪(fǎng)并比較兩組患者手術(shù)前后疼痛視覺(jué)模擬評(píng)分(visual analogue scale,VAS)、美國(guó)特種外科醫(yī)院(hospital for special surgery,HSS)膝關(guān)節(jié)評(píng)分、血紅蛋白、總失血量、輸血量、手術(shù)時(shí)間、住院時(shí)間、住院期間總花費(fèi)及觀(guān)察術(shù)后并發(fā)癥情況。結(jié)果 85例患者獲得滿(mǎn)意隨訪(fǎng),隨訪(fǎng)時(shí)間3~5個(gè)月。與TKA組患者相比,腓骨截骨組患者的總出血量、輸血量、手術(shù)時(shí)間、住院時(shí)間、總花費(fèi)較少(P0.05);與術(shù)前相比,術(shù)后兩組患者的HSS評(píng)分均明顯升高、VAS評(píng)分均顯著降低(P0.05),VAS和HSS評(píng)分的組間比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);術(shù)后TKA組患者的血紅蛋白含量明顯降低(P0.05),腓骨截骨組患者的血紅蛋白含量無(wú)顯著變化(P0.05)。結(jié)論腓骨近端截骨術(shù)可獲得與TKA相似的近期療效,且具有創(chuàng)傷小、失血少、花費(fèi)低、手術(shù)及住院時(shí)間短等優(yōu)點(diǎn),值得臨床推廣。
[Abstract]:Objective to compare the short-term efficacy of fibula proximal osteotomy and total knee arthroplasty (total knee replacement,TKA) in the treatment of varus knee osteoarthritis. Methods from April 2015 to July 2015, 103 patients with varus knee osteoarthritis treated with fibula proximal osteotomy and TKA were analyzed retrospectively, and 85 patients met the criteria of inclusion and exclusion. The fibula osteotomy group and the TKA group were divided into two groups according to the different operative methods. There were 40 patients in fibula osteotomy group, 11 males (27.5%) and 29 females (72.5%). The average age of TKA group was (65.4 鹵8.6) years old, with a mean age of (65.4 鹵8.6) years. There were 14 males (31.1%) and 31 females (68.9%), with a mean age of (64.3 鹵7.6) years. The patients were followed up 7 days, 1 month, 2 months and 3 months before and after operation respectively. The pain visual analogue score (visual analogue scale,VAS), the knee joint score (hospital for special surgery,HSS), hemoglobin, total blood loss, blood transfusion volume were compared between the two groups before and after operation. Operation time, total cost during hospitalization and postoperative complications were observed. Results 85 patients were followed up satisfactorily for 3 ~ 5 months. Compared with the TKA group, the total blood loss, blood transfusion, operation time, hospital stay in the fibula osteotomy group were less than those in the fibular osteotomy group (P0.05). The HSS scores of the two groups were significantly increased after operation (P0.05). There was no significant difference between the VAS and HSS scores (P0.05), the hemoglobin content in the TKA group was significantly lower (P0.05), and the blood red in the fibula osteotomy group was significantly lower than that in the fibula osteotomy group (P0.05). There was no significant change in protein content (P0.05). Conclusion the proximal fibula osteotomy is similar to TKA and has the advantages of less trauma, less blood loss, low cost, short operation and hospital stay, etc. It is worthy of clinical promotion.
【作者單位】： 內(nèi)蒙古自治區(qū)赤峰市醫(yī)院骨關(guān)節(jié)科;華中科技大學(xué)同濟(jì)醫(yī)學(xué)院附屬協(xié)和醫(yī)院骨科;
【基金】：國(guó)家自然科學(xué)基金青年基金項(xiàng)目(30901523)
【分類(lèi)號(hào)】：R687.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 陳偉;秦迪;吳濤;張飛;陳啟明;張英澤;;應(yīng)用腓骨截骨術(shù)治療膝關(guān)節(jié)骨性關(guān)節(jié)炎效果優(yōu)良的機(jī)制分析[J];河北醫(yī)科大學(xué)學(xué)報(bào);2015年06期

【共引文獻(xiàn)】

相關(guān)期刊論文 前9條

1 王宏偉;扶世杰;;80例全關(guān)節(jié)置換翻新術(shù)的回顧性分析[J];遼寧醫(yī)學(xué)院學(xué)報(bào);2014年05期

2 吳廈;蔡，

本文編號(hào)：2247442