类风湿关节炎患者全膝置换术术前评估
刘大猛
周新社
1.蚌埠医学院第一附属医院骨科, 安徽,2330002.蚌埠医学院第一附属医院骨科, 安徽,233000
摘要：Total knee arthroplasty ( TKA ) is developing. Rheumatoid arthritis ( RA ) patients, whose knee function is severely affected, have obtained good effects. RA can not only affect the joints, but a systemic and multi-systematic disease. When involving the cervical spine, RA can cause upper cervical instability. It is essential to pay more attention to asymptomatic patients, so as to select appropriate treatment measures. Preoperative heart function rating can assess the risk of surgery and the tolerance of patients. The pulmonary injury often slacks up lung functions too. RA patients also have higher prevalence of oral or periodontal diseases, which is related with artificial joint infection after the surgery. Anemia can lead to increased risk of infection and delayed wound healing. So for each body the comprehensive and systematic preoperative evaluation is necessary. In addition, degree of preoperative rheumatoid arthritis and inflammatory indexes such as blood sedimentation, c-reactive protein level are of controversy. The use of clinical drugs to relieve symptoms before surgery or not is worth the attention of orthopedic surgeons. Patients with long-term drug therapy, such as traditional DMARDs and biological agents, cortisol, have the risk of infection after the knee replacement. Researches on biological agents in the treatment of rheumatoid arthritis are being conducted in recent years. Foreigners also put forward the guide on the perioperative use of biological agents. Detailed preoperative evaluation and multidisciplinary cooperation are necessary to reduce the risk of surgery.
关键词：关节炎类风湿人工膝关节关节成形术置换膝风险调节膝关节
分类号：R687.4(骨科学（运动系疾病、矫形外科学）)R684(骨科学（运动系疾病、矫形外科学）)
论文发表日期：2016-01-01
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：5( 153-157 )
英文信息