투석을 시행하는 만성 신부전 환자의 인공 고관절 치환술 시 합병증에 대한 분석

국문 초록 (Abstract)

목적: 투석을 시행받는 만성 신부전 환자에 대한 수술적 치료는 결과 및 예후가 일반 환자군에 비해 불량하여, 인공 고관절 치환술을 시행받은 만성 신부전 환자의 수술과 관련된 합병증에 대한 결과적 차이를 분석하고자 하였다.
대상 및 방법: 투석 중인 만성신부전 환자에서 양극성 반치환술이나 고관절 전치환술을 시행한 38명의 환자, 총 40예를 대상으로 합병증의 종류와 빈도 및 연령, 성별, 투석 기간, 당뇨 합병 여부에 따라 환자군을 분류하여, 술 후 1년 내 수술과 관련된 합병증에 대해 분석하였다.
결과: 술 후 1년 내 총 15예에서 정형외과적 혹은 내과적 합병증이 발생하였고(37.5%), 사망은 전체 8예(20%)였다. 성별 및 투석 기간에 따른 분류에서는 합병증 발생 및 사망률에 있어 통계학적으로 유의한 차이점은 발견할 수 없었으나, 연령(p=0.014) 및 당뇨(p=0.026) 합병 여부에 따른 분류에서는 합병증 발생에 있어서 유의한 차이점을 발견할 수 있었다.
결론: 투석을 시행하는 만성 신부전 환자에서 시행한 인공 고관절 전치환술은 다양한 합병증이 발생할 수 있으며, 특히 고령 환자 및 당뇨가 동반된 경우 보다 세심하고 철저한 수술 전 치료 계획 및 술 후 관리를 통해 합병증을 줄이려는 노력이 필요하다.

다국어 초록 (Multilingual Abstract)

Purpose: In general, the results and prognosis of surgical treatment in dialysis patients are poor compared to patients with normal kidney function. This study analyzes the complications in chronic renal failure patients who underwent primary hip arthroplasty for hip fractures and arthropathy. Orthopaedic complications and medical complications were analyzed for a consequential difference.
Materials and Methods: Between 2003 and 2008, 38 dialysis patients (40 cases) with chronic renal failure were enrolled with 24 cases of bipolar hemiarthroplasty and 16 cases of total hip arthroplasty. Types and rates of orthopaedic and medical complications were investigated. Patients were classified according to age, gender, duration of dialysis and diabetes mellitus status. Complications were analyzed for each group.
Results: Complications occurred in 15 patients (overall complication rate: 37.5%). Eight patients were died within 1 year (mortality: 20%). Gender and duration of dialysis were not correlated to number of complications. However, there were significant differences according to age (p=0.014) and having diabetes (p=0.026). With regard to mortality, there was no significant difference according to the above classification.
Conclusion: Patients on hemodialysis have a high risk of complications after primary hip arthroplasty, especially in elderly patients and diabetic patients. Therefore, we require a full disclosure before recommending hip arthroplasty surgery in dialysis patients, and close postoperative care in patients undergoing dialysis.

목차 (Table of Contents)

• 서론
• 대상 및 방법
• 결과
• 고찰
• 결론
• 참고문헌

참고문헌 (Reference)

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