最常見(jiàn)并發(fā)癥是下肢深靜脈血栓形成

1、最常見(jiàn)并發(fā)癥是下肢深靜脈血栓形成?最嚴(yán)重的并發(fā)癥是感染?最重要的長(zhǎng)期并發(fā)癥是關(guān)節(jié)松動(dòng)及磨損1.深靜脈血栓形成深靜脈血栓形成DeepVenousThrombosis(DVT)?最常見(jiàn)并發(fā)癥mostcommoncomplication–血栓停留在下肢問(wèn)題并不太嚴(yán)重Aslongastheclotsremaininthelegstheyarearelativelyminproblem.–如果血栓脫落經(jīng)心臟栓塞肺動(dòng)脈可導(dǎo)致死亡Occasional

2、lytheydislodgetravelthroughthehearttothelungs(pulmonaryembolism).deathcanresultfromembolism.–肺栓塞發(fā)生率為數(shù)百分之一ThechancesofPEareoneoutofseveralhundred.?鼓勵(lì)患者盡早活動(dòng)Encouragingactivityassoonaspossible?壓力襪子促進(jìn)血液流動(dòng)Pressurestockingstok

3、eepthebloodinthelegsmoving?藥物應(yīng)用防止血栓Medicationsthatthinthebloodpreventbloodclotsfromfming2.感染感染Infection?初次關(guān)節(jié)置換感染率1%，翻修手術(shù)感染率3%About1%ffirstOPfrevision3%?預(yù)防Prevention–層流手術(shù)室laminarflowoperatingroom–抗菌素合理應(yīng)用Antibiotics–縮短手術(shù)時(shí)間

4、Shtenoperationtime…–好的經(jīng)驗(yàn)Goodexperience?感染高發(fā)因素Highinfectionrate–類風(fēng)濕性關(guān)節(jié)炎或糖尿病rheumatoidarthritisdiabetes–長(zhǎng)時(shí)間應(yīng)用激素takingctisonefprolongedperiodsoftime–既往關(guān)節(jié)感染病史jointhashadpreviousinfection–手術(shù)時(shí)身體其他部位感染（牙齒、膀胱等）haveinfectionanywh

5、ereelse(teethbladderetc.)atthetimeofsurgery.3.假體松動(dòng)假體松動(dòng)Looseningoftheprosthesis?取決于Dependenton–手術(shù)好壞Howwellthesurgeryisdone?Completefracturemayrequireseparatesurgeryffixation.Smallcracksmayneedtobetreatedwithwires.8.殘余疼痛及關(guān)

6、節(jié)僵硬Residualpainstiffness?Somepatientshavepainaftersurgerywhichcannotbeexplained?Somepatientswithuncementedhipreplacementsdevelopthighpain.?Thepainisusuallymildalmostalwaysresolvesafter18to24months.?Ithasbeenfoundthatthel

7、argerthediameteriftheimplantinstalledthemelikely“thighpain”willdevelop.?FthisreasonDr.Huddlestonalmostneverinstallsanuncementedfemurimplantlargerthan17millimetersindiameter.9.術(shù)后下肢不等長(zhǎng)術(shù)后下肢不等長(zhǎng)AlterationofLimbLengthPostopera

8、tively10.下肢血管神經(jīng)損傷Injurytothearteriesnervesoftheleg?exceedinglyrare?sciaticnerveinjury0.2%11.出血并發(fā)癥出血并發(fā)癥Bleedingcomplications.?hematomafmation.?Itmaydistendthehipcausedislocation.?Ifitisexcessiveitmayrequirereopeningthewou

9、ndunderanesthesiatoletthebloodout.12.麻醉并發(fā)癥Anestheticcomplications?veryrarelyevendeathcanoccurfromtheanesthesia.13.輸血并發(fā)癥輸血并發(fā)癥ComplicationsFromBloodTransfusions?AIDS1:2000000?HepatitisB1:550?HepatitisC1:100?allergicreactio