亚伯体育

膝关节骨关节炎是关节外科常见的慢性关节疾患，具有患病率高、病变范围广、晚期功能障碍程度重等特点。调查结果显示，在40～60 岁的人群中，骨关节炎的患病率为10％～17％； 60岁以上人群中，骨关节炎的患病率达50％；而在> 75岁人群中， 80％患有骨关节炎。

yinggaishuomuqianshangmeiyourenhezhiliaofangshikeyishiguguanjieyandebingchengnizhuanhetingzhi，guguanjieyandezhiliaomudeshihuanjietengtong，yanhuanbingbianfazhan；zaoqizhengquedezhiliaokeyimingxianxiaochuzhengzhuang，gaishanguanjiegongneng，shijibingbuyingxianghuanzhedeshenghuozhiliang；wanqiguguanjieyanhuanzhe,yingjijicaiqushoushuzhiliao,yibimianguanjieyanzhongjixingdefasheng。muqiandezhiliaozhuyaocaiyongjietiliaofa，jizaoqicaiyongfeiyaowu（huanzhejiaoyu、wulizhiliao、jirouxunlian、tizhongkongzhi、fuzhuzhijudeng）、yaowuzhiliao（gaishanzhengzhuangyaowu、gaishanjiegouyaowu），danghuanzheyoujiaoyanzhongdechixuxingtengtongjimingxiandeguanjiehuodongzhangai，baoshouzhiliaowuxiao，yingxianggongzuojishenghuoshi，zekaolvshoushuzhiliao，duiyuzao、zhongqiguguanjieyanhuanzhe，kezaiguanjiejingxiaxingguanjieqinglishu，xiaoguolianghao。wanqichuxianjixinghuochixuxingtengtongshi，kegenjuhuanzhejutiqingkuangxuanzeguanjiezhouweijiegushujirengongguanjiezhihuanshu。neimenaxiexiguanjieguguanjieyanhuanzheshiheguanjiejingshoushuni？tongchangyabotiyuxuanzetengtongshijianduan＜3geyue；youniushangshi；youmingquedejixiezhengzhuangrukagan、jiaosuohuohuanxishenzhishouxian；guanjiejiye、guanjiexianyatong、mcmurrayzheng（＋）；neifanjixing＜ 10°，waifanjixing＜ 15°。zaishiyingzhengxuanzeheshideqingkuangxiaguanjiejingzhiliaoxiguanjieguguanjieyanhuiqudehuanjiezhengzhuang、gaishangongneng、yanhuanbingqingfazhandeliaoxiao。

rengongguanjiezhihuanshuyongyuyanzhongdeguxingguanjieyan;

shangxufuheyixiabiaozhuncaishiyijinxingrengongguanjiezhihuanshu: ①guanjiemianguheruangupohuaideyingxiangxuegaibian；②youzhongdudaozhongduchixuxingtengtong；③jingguozhishaobanniandebaoshouzhiliao，gongnenghetengtongwufagaishan。baoshouzhiliaozhishaoyingbaokuo: feizaitileikangyanyaowujiqitaleixingdezhitengyaowu、liliao、zhuxingzhuangzhi（shouzhang、guaizhangdeng）yijiyouyishidejianshaoguanjiefuhedeshenghuo、gongzuoxiguandegaibian；④huanzhenenggoujijipeiheyishengzhiliao，youlianghaodeyicongxing；

nianlingyifeirengongguanjiezhihuandejuedingxingyinsu。zuichu，shouxianyuzaoqiderengongguanjiejiatishejijicailiaomosunxingnengdexianzhi，yijishoushujishushangbuchengshu，yidurenweirengongguanjiezhihuanzhishiyongyu65suiyishangrenqun。 dansuizhegengduodexinxingnaimocailiaozairengongguanjiezhongguangfanyingyong，shoushujishutebieshifanxiujishudedafudutigao，gezhongfanxiujiatishejiriquwanshan，errenmenduishenghuozhiliangdeyaoqiuyebuduantigao，yuelaiyueduodegaolingrenqunhenianqingrenyinweiyanzhongdeguanjiejibingjieshourengongguanjiezhihuanshu。

chenggongdeyaosu（4pyaosu）

亚伯体育（1） （patient selection）bixuxuanzeheshishiyingzhengdehuanzhe

rengongguanjiezhihuanshujinguanyijinghuodehendadechenggong，danrengrannanyimanzunianqinghuanzhedahuodongliang，zhangqishiyongdeyaoqiu；duiyumouxiegaolinghuanzhe，qibansuiyouqitaqiguandeyanzhongjihuan，huozhenanyipeiheyishengjinxingzaoqideguanjiegongnengkangfu，yebushiyuguanjiezhihuan。baozhenghuanzheanquanyongyuanshirengongguanjiezhihuanshuyaokaolvdediyiweidewenti。

huanzhebixujubeimanzushoushuyaoqiudequanshenzhuangkuangjilianghaodejingshenzhuangtai，tongshiyaoduirengongguanjiezhihuanshuyouhelideyuqi。

（2） （procedure）shoushucaozuojishu

rengongguanjiezhihuanshuduiyishengdeshoushucaozuojishuyaoqiuhengao。

shouxianrengongguanjiezhihuanshuzhongchuleyaoduiguanjiedebingzaojinxingqiechuyiwai，xuyaoshenkelijieguanjiedeyundongxueyuanli，jiangrengongguanjiedejiatianzhuangzaizhunquedeweizhi，jinengshijiatihuodelianghaodewendingxing，younenghuifuguanjiedezhengchangyundong。

qici，rengongguanjiezhihuanshuzhongyaoshiyongdaodaliangdegongjuqixie。yishengbixuzhangwogongjuqixiedeshejiyuanli，shuxishiyongfangfa，zheijiuxuyaodaliangdelilunxuexihelinchuangshijian。zaiyabotiyuguo，haiyouyigetedian，jiduoshuhuanzhezaixunqiuguanjiezhihuanshi，guanjiejibingyizhiwanqi，cunzaiyanzhongdeguanjiejixingheguquesundengqingkuang。zheigengxuyaoyishengyouzhashidelilunjichujifengfudelinchuangjingyan，cainenglinghuodechulishoushuzhongchuxiandefuzaqingkuang。guowaiyouyanjiubiaoming，nianshoushuliangxiaoyu30lideyishengzhiliaodehuanzhegengrongyichuxianbingfazheng。

亚伯体育（3） （prosthesis selection）jiatixuanze

亚伯体育xuduohuanzhejiandandelijieweirengongguanjiejiati“yueguiyuehao，yuexinyuehao”。

qishiburan，shouxian，rengongguanjiejiatixuyaozairentineizhangqifahuixiaoneng，erxindejiatiwangwangjinzaishiyanshineijingguomoniceshi。jinguanshiyanshujubiaomingkeyishiyongjiaozhangshijian，danyouyurentihuanjingjiqifuza，guanjiejiatinengfouzairentineifahuizhangqixiaonengzecunzaiyiwen，xuyaoshijianjianyan。

qici，rengongguanjiejiatizhongleifanduo，qishejidejiepouxueshujulaiziyubutongzhongzuderenqun，chuzhongshizhenduibutongleixingjibingdehuanzhe，yinciguidejiati、xindejiatiweibishizuishihenindejiati。

zaize，yishengduiyujiatideshuxichengduyezaihendachengdushangjuedinglelinchuangdejieguo，yizhongxindejiati，kenengganggangjinrudaolinchuangshiyong，yishenghaiquefashijianjingyan，duiyujiatidetexingkenenghaibushuxi，fanerhuiyanzhangshoushushijian，zengjiashuhoubingfazheng。

yinci，gengweizhunquedelijieshi，“meiyouzuihaodejiati，zhiyouzuishihenidejiati”。

（4） （peri-operation management）weishoushuqiguanli

亚伯体育yilirengongguanjiezhihuanshudechenggong，shiyigetuanduigongtongnulidejieguo。shoushuyishengzaiqizhongbanyanzhuyaojiaose，ermazuishi、neikeyisheng、hushi、kangfushidengtongyangzhongyaoerbukehuoque。xifangfadaguojiaderengongguanjiezhihuanshuyijingfeichangchengshu，yincizairengongguanjiezhihuandeyiliaozhongxinxingchengleyigewendingdetuandui，duiyuxuyaojinxingrengongguanjiezhihuandehuanzhecaiyongbiaozhunhuadechuliliucheng。zheidadatigaoleshoushudeanquanxinghechenggonglv，yesuoduanlehuanzhedezhuyuanshijianjijiangdilehuanzhedeyiliaozhichu。

weishoushuqiguanlishejihuanzheshuqianquanshenzhuangkuangdepinggu，mazuipinggujicaozuo，shuzhongshoushuyishengjiqixiehushideshulianpeihe，shuhouzhiteng，kangganran，kangfudengzhuduofangmian。

亚伯体育chenggongderengongguanjiezhihuanshuyishangsigeyaosuqueyibuke。