目的：探讨全膝关节置换术治疗类风湿关节炎的临床疗效及对患者D-二聚体水平的影响。方法对26例（29膝）类风湿性关节炎患者行全膝关节置换术，观察对比术前与术后2年HSS评分、疼痛评分及D-二聚体水平。结果29膝中，优17膝，良8膝，优良率为86.21%。术后2年，患者疼痛评分显著升高（P<0.05），HSS评分及D-二聚体水平均显著降低（P<0.05）。X线片显示膝关节假体位置、力线良好，假体无松动迹象。结论全膝关节置换术能有效缓解类风湿性关节炎患者的疼痛，降低血浆D-二聚体水平，改善患者膝关节功能。%Objective To investigate the clinical efficacy of total knee arthroplasty and its effect on the D-dimer levels of rheuma-toid arthritis patients. Methods 26 patients (29 knees) with rheumatoid arthritis were treated with total knee replacement surgery, the HSS score, pain score and D-dimer levels pre-operation and 2 years post-operation were observed and compared. Results Of the 29 knees, 17 knees were excellent, good in 8 knees, the excellent and good rate was 86.21%. 2 years after the operation, the pain scores of the patients were significantly higher than those before the operation (P<0.05), HSS score and D-dimer levels were significantly lower than those before the operation (P<0.05). X-ray showed that knee prosthesis position, force lines were all good with no signs of loosening. Conclusion Total knee arthroplasty can effectively relieve pain, reduce plasma D-dimer levels, and im-prove the knee function in patients with rheumatoid arthritis.
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