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目的探讨HIV阳性患者骨科疾病的有效治疗方法及围手术期的处理。方法回顾性研究1999年1月至2009年1月在新疆医科大学第一附属医院骨科进行手术的HIV阳性患者62例,作为研究组,男52例,女10例;年龄5～63岁,平均32.4岁。按WHO标准进行临床分期,Ⅰ期48例,Ⅱ期10例,Ⅲ期4例,对不同临床分期患者进行不同方式的手术治疗及围手术期的处置。同时随机选取同期HIV阴性实施同等级别骨科手术的患者70例,作为对照组。分析2组患者手术前、后的临床资料。结果术后随访1～5个月,平均3个月。67.5%的研究组患者术前存在血红蛋白低、白细胞计数低、淋巴细胞计数低、血沉高等,且以上因素2组间存在统计学差异。研究组手术后感染机率明显高于对照组,且随着临床分期的提高合并感染的机率明显增加。结论针对不同的临床分期制定围手术期的处置是HIV阳性患者进行骨科手术的安全有效的方法。
Objective To investigate the effective treatment and treatment of orthopedic diseases in HIV positive patients. Methods A retrospective study of 62 cases of HIV-positive patients undergoing surgery in the orthopedics department of the First Affiliated Hospital of Xinjiang Medical University from January 1999 to January 2009 was performed. The study group consisted of 52 males and 10 females, aged 5 to 63 years 32.4 years old. According to the WHO standard clinical staging, Ⅰ 48 cases, Ⅱ 10 cases, Ⅲ 4 cases, different clinical staging of patients with different ways of surgical treatment and perioperative management. In the meantime, 70 patients with the same grade of orthopedic surgery during the same period were randomly selected as the control group. The clinical data of two groups before and after operation were analyzed. Results Postoperative follow-up 1 to 5 months, an average of 3 months. 67.5% of the study group patients had low hemoglobin, low white blood cell count, low lymphocyte count and high erythrocyte sedimentation rate before the operation, and the above two factors were statistically different. The probability of postoperative infection in the study group was significantly higher than that in the control group, and the probability of co-infection was significantly increased with the clinical stage. Conclusion Perioperative management of different clinical stages is a safe and effective method for orthopedic surgery in HIV-positive patients.