肥胖对全髋关节置换术后的早期疗效影响分析

目的 探讨肥胖对全髋关节置换术(THA)后的早期疗效影响分析。方法 对我科2014年11月至2016年9月期间300例需要行THA的患者根据入院时人体质量指数(BMI)分为肥胖组(107例,BMI≥25)与非肥胖组(193 例,BMI＜25),比较两组患者术中和术后出血量、手术时间、术后3个月内并发症发生率(假体骨折、脱位、感染、深静脉栓塞),并分别在术后1、2、6个月时间比较患侧髋关节Harris评分变化,将以上数据并进行统计学分析。结果 肥胖组和非肥胖组相比较,前者在术中和术后出血量、手术时间、深静脉栓塞及术后3个月内并发症总数发生率均高于非肥胖组,差异具有统计学意义(P＜0.05);而术后假体脱位、假体骨折及感染的发生率,肥胖组虽然高于非肥胖组,但差异无统计学意义(P＞0.05)。术后第1、2、6个月的髋关节Harris评分非肥胖组高于肥胖组,差异具有统计学意义(P＜0.05)。结论 肥胖会增加THA术中难度,增加THA术后早期并发症的发生率,同时对患者术后早期髋关节的功能恢复有影响。

Effect of obesity on early outcome after total hip arthroplasty

Objective To investigate the effect of obesity on the early outcome of total hip arthroplasty (THA) after total hip arthroplasty (THA).Methods From November 2014 to September 2016,300 patients who underwent total hip arthroplasty were divided into obese group (107 cases,BMI≥25)and non-obese group (193 cases,BMI＜25) according to the body mass index (BMI). The complications were compared between the two groups (intraoperative and postoperative bleeding volume,operation time and postoperative complications within 3 months) (prosthesis fracture, dislocation, Vein embolization). The Harris score of the hip joint was compared with that of the hip joint at 1 month, 2 months and 6 months postoperatively. The above data were analyzed statistically.Results Compared with the non-obese group, the total complication rate of the former group was higher than that of the non-obese group in the intraoperative and postoperative blood loss,operation time and postoperative 3 months (P＜0.05).The incidence of postoperative prosthesis dislocation,prosthesis fracture and deep vein thrombosis was higher in the obese group than in the nonobese group (P＜0.05),but the difference was not statistically significant (P＜0.05).The Harris score of the hip joint in the non-obese group was significantly higher than that in the obese group at 1 month,2 months and 6 months postoperatively (P＜0.05).Conclusion Obesity increases the difficulty of THA,increases the incidence of early complications after THA,and affects the early functional recovery of the hip.