最常见并发症是下肢深静脉血栓形成VIP免费

最常见并发症是下肢深静脉血栓形成•最严重的并发症是感染•最重要的长期并发症是关节松动及磨损1.深静脉血栓形成DeepVenousThrombosis(DVT)•最常见并发症mostcommoncomplication–血栓停留在下肢问题并不太严重Aslongastheclotsremaininthelegstheyarearelativelyminorproblem.–如果血栓脱落经心脏栓塞肺动脉可导致死亡Occasionallytheydislodgeandtravelthroughthehearttothelungs(pulmonaryembolism).deathcanresultfromembolism.–肺栓塞发生率为数百分之一ThechancesofPEareoneoutofseveralhundred.•鼓励患者尽早活动Encouragingactivityassoonaspossible•压力袜子促进血液流动Pressurestockingstokeepthebloodinthelegsmoving•药物应用防止血栓Medicationsthatthinthebloodandpreventbloodclotsfromforming2.感染Infection•初次关节置换感染率1%，翻修手术感染率3%About1%forfirstOP,forrevision3%•预防Prevention–层流手术室laminarflowoperatingroom–抗菌素合理应用Antibiotics–缩短手术时间Shortenoperationtime…–好的经验Goodexperience•感染高发因素Highinfectionrate–类风湿性关节炎或糖尿病rheumatoidarthritisordiabetes–长时间应用激素takingcortisoneforprolongedperiodsoftime,–既往关节感染病史jointhashadpreviousinfection–手术时身体其他部位感染（牙齿、膀胱等）haveinfectionanywhereelse(teeth,bladder,etc.)atthetimeofsurgery.3.假体松动Looseningoftheprosthesis•取决于Dependenton–手术好坏Howwellthesurgeryisdone–骨的质量Thequalityofbones–活动情况Howactive–体重Weight–假体是否应用骨水泥，目前认为非骨水泥假体使用时间长于骨水泥假体Whetherornottheimplantiscemented:Atpresentitisbelievedthatuncementedimplantswilllastlongerthancementedones–假体设计Thedesignoftheimplant4.聚乙烯臼衬磨损WearofthePlasticPolyethyleneSocket•about0.1millimetersperyear•morerapidinveryactivepatients•“Cross-linked”polyethylene（高交链聚乙烯HXLPE）promisesawearrateabouthalfthatofPE(普通聚乙烯)•Plastic--ceramicballismuchlesswear•Metal-on-metalbearingswillneverwearout.•Norwillceramic-on-ceramicimplants,butthereisa1/20,000riskoffractureoftheceramicball.5.关节脱位Dislocationofthehipreplacement•morelikelytodislocateinthefirst6weeks•About2%Preventionofdislocation•Donotcrosslegs•Donotflexlegsupbeyond90degrees•Donotsitonsofasorinlowchairs•Donotsleeponaffectedside6.异位骨化Ectopicboneformation•causesthehiptobestifferthandesired7.股骨骨折Fractureofthefemur•morecommonduringrevisionhipsurgery•Completefracturemayrequireseparatesurgeryforfixation.Smallcracksmayneedtobetreatedwithwires.8.残余疼痛及关节僵硬Residualpainandstiffness•Somepatientshavepainaftersurgerywhichcannotbeexplained•Somepatientswithun-cementedhipreplacementsdevelopmidthighpain.•Thepainisusuallymild,andalmostalwaysresolvesafter18to24months.•Ithasbeenfoundthatthelargerthediameteriftheimplantinstalledthemorelikely“thighpain”willdevelop.•Forthisreason,Dr.Huddlestonalmostneverinstallsanun-cementedfemurimplantlargerthan17millimetersindiameter.9.术后下肢不等长AlterationofLimbLengthPostoperatively10.下肢血管神经损伤Injurytothearteriesornervesoftheleg•exceedinglyrare•sciaticnerveinjury0.2%11.出血并发症Bleedingcomplications.•hematomaformation.•Itmaydistendthehipandcausedislocation.•Ifitisexcessive,itmayrequirere-openingthewoundunderanesthesiatoletthebloodout.12.麻醉并发症Anestheticcomplications•veryrarelyevendeathcanoccurfromtheanesthesia.13.输血并发症ComplicationsFromBloodTransfusions•AIDS1:2000000•HepatitisB1:550•HepatitisC1:100•allergicreaction1:500•HemolyticTransfusionReactionis1in10,00014.脂肪栓塞FatEmbolism•Fatfromthebonemarrowcangetintothecirculationandcauselungorneurologicalsymptoms.•Thisisaveryrarecomplication.•Inveryrarecasesitcanbefatal15.其它轻微并发症Otherminorcomplications•allergiestomedications•Allergytothemetalparts•Infectioninlung，urinetract•Bedsore•Therearerisksineverythingwedoinlife