肾移植患者人工髋关节置换的特点和疗效观察

目的探讨肾移植患者人工髋关节置换的治疗特点，并观察其疗效。方法回顾2006年11月至2009年3月肾移植术后行人工髋关节置换术患者3例（4髋），对术前评估、术中操作、假体选择、术后免疫抑制方案调整和抗凝等综合治疗进行分析和小结。结果3例患者在围手术期经过综合处理，均未出现移植肾排斥、多器官功能不全、感染和血栓等严重并发症。平均随访3．4年，目前功能恢复良好，无相关并发症。结论肾移植术后患者进行人工髋关节置换术时，由于自身的特殊情况，术前及术后都需进行全面、系统的综合治疗。在保证移植肾充分安全的前提下，才能避免严重并发症的发生，获得人工髋关节置换术的成功。

The Characteristics and Clinical Effect of Hip Arthroplasty after Renal Transplantation

Objective To discuss the characteristics and effect of hip arthroplasty after renal transplantation. Methods We reviewed the clinical data of hip arthroplasty （4 hips） in 3 renal transplant patients from November, 2006 to March,2009. We utilized the comprehensive and multiple considerations during the perioperative period such as preoperative evaluation, surgical technique, prosthesis selection,immunosuppressive drug use and anticoagulative strategy. Results There was no infection,thrombosis,complications o~ the transplanted kidney or multiple organ dys- functions in all patients using comprehensive perioperative care. Outcome was promising and no complication was re- ported after an average follow up of 4.2 year. Conclusion Comprehensive care and evaluations during perioperation are important for hip arthroplasty after renal transplantation. Maintaining transplanted kidney safe is critical during perioperative care.