类风湿关节炎(RA)是最常见的关节疾病之一。其早期主要侵犯关节滑膜，随病情进展侵犯软骨组织及软骨下骨，最终导致骨质破坏及骨缺损，甚至关节畸形。人工关节置换术作为中晚期RA的主要治疗方式，能够显著改善关节功能、缓解临床症状。RA作为一种常见的自身免疫性疾病，往往伴随多种合并症，且大多数中晚期RA患者会长期服用抗类风湿药物来缓解症状，其中包括非甾体抗炎药、糖皮质激素及改善病情抗风湿药物等。众多因素导致围术期的并发症显著增多，因此，如何完善RA患者围术期管理、减少术后并发症就显得尤为重要。本文拟从RA患者行关节置换围术期的风险评估、用药管理、术后并发症及防治、术后功能康复等方面，结合国内外相关文献加以概括总结，旨在为临床RA患者围术期管理提出有益帮助。

Rheumatoid arthritis (RA) is one of the most common joint diseases with direct invasion of joint synovial membrane, cartilage and subchondral bone, resulting in bone defect and even joint deformity finally. Artificial joint arthroplasty has become the main measurefor patients of advanced RA, and can improve joint function and clinical symptoms. RA is an autoimmune disease, with a variety of complications, and most advanced RA patients receive continuously anti-rheumatoid drugs, including nonsteroidal anti-inflammatory drugs, glucocorticoids and disease modifying anti-rheumatic drugs before surgery. These factors can lead to increase perioperative complications. Thus, how to improve the perioperative management of RA patients and reduce postoperative complications is particularly important. This article intended to summarize the perioperative risk assessment, usage of perioperative drugs, postoperative complications and prevention, postoperative functional rehabilitation of RA patients treated with joint replacement, combined with relevant literature at domestic and overseas, so as to provide beneficial help for the perioperative management of clinical RA patients.