摘要
目的探讨人工全膝关节感染翻修医疗费用中的各项组成与手术方式的相关性,为人工全膝关节感染翻修方式的选择提供参考。方法统计2000年到2010年于本组因感染行人工全膝关节翻修术的患者,并按纳入标准选取符合要求的患者23例,男5例,女18例;年龄50～85岁,平均66.6岁。分析并比较其围手术期发生相关费用组成,同时选取同期年龄、性别、基础疾病匹配的初次人工关节置换患者,并对一期、二期翻修及初次人工关节置换进行费用对比,应用SPSS16.0统计软件对数据进行处理。结果 23例患者翻修手术的平均费用为(98736.94±44330.23)元,一期翻修住院时间及治疗费用明显较二期翻修者少,差异具有统计学意义(t=2.84,P<0.05;t=2.94,P<0.05);与初次膝关节置换相比,翻修手术住院日及翻修费均明显增加,差异具有统计学意义(t=7.165,P<0.05;t=5.678,P<0.05)。翻修手术中更换部分关节假体组件的翻修方式较全部更换更为经济,但风险更大。翻修假体及围手术期抗生素的应用仍然是整个医疗费用中最大的部分,占整个治疗疗费用77.42%。结论膝关节感染是膝关节置换术后翻修的重要原因,选择合适的治疗方式和手术方案可以极大的减少医疗费用的消耗。
Objective To explore the cost of total knee revision surgery and analyse correlation between operation mode and composition of fee. Methods From 2000 to 2007, 23 patients underwent total knee revision surgery were selected according to inclusion criteria. There were five males and 18 females （ age ranging from 50 to 85 years, 66. 6 years in average）. Patients were matched with age, sex, and diseases. Their perioperative costs and compositions were compared;the correlation between operation modes and cost composition was analysed. The data were processed by statistical software SPSS 16. 0. Results The average cost of 23 patients were （98 736. 94 ± 44 330. 23 ） RMB. The cost and hospital time of patients underwent one-stage surgery were much more than who underwent two-stage surgery. The difference was significant （ t = 2. 84, P 〈 0. 05 ; t = 2. 94, P 〈 0. 05 ）. Compared with the primary total knee arthroplasty, the cost and length of stay were increased in revision surgery, and the difference was significant （t =7. 165, P 〈0. 05; t =5. 678, P 〈0. 05）. It is more economical to replace the component than total revision, but with greater risk. The consume of prosthesis and antibiotic was about 77.42% of the cost, much more than other pans. Conclusions Infection after total knee arthroplasty was the most common reason for revision surgery. It is important to select the appropriate treatment and operation mode to reduce the medical costs.
出处
《中华关节外科杂志（电子版）》
CAS
2012年第6期25-27,共3页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
费用
医疗
关节成形术
置换
膝
翻修
Fees, medical
Arthroplasty, replacement, knee
Revision
