摘要
目的全膝关节置换术(total knee replacement,TKR)出血量大,探讨股骨髁间闭合式人工膝关节假体有无减少TKR手术出血量的作用。方法2005年6月-2006年12月,对108例原发性膝关节骨性关节炎患者施行单、双膝TKR术。患者全身状况良好,无手术禁忌证。采用髁间闭合式膝关节假体54例(A组),男7例,女47例;年龄41~76岁,病程4~16年;其中单膝TKR组(A1组)27例,双膝TKR组(A2组)27例。采用髁间开放式膝关节假体54例(B组),男8例,女46例;年龄59~81岁,病程8~26年;其中单膝TKR组(B1组)27例,双膝TKR组(B2组)27例。患者均在相同麻醉下由同一组医生完成手术,比较A、B两组术后出血量和手术总出血量。结果术后出血量:A1、A2、B1及B2组分别为(890±352)、(1694±528)、(1068±386)及(2065±622)mL;A1与B1组比较,差异无统计学意义(P>0.05);A2组与B2组比较,差异有统计学意义(P<0.05)。手术总出血量:A1、A2、B1及B2组分别为(1095±329)、(2082±594)、(1274±415)及(2459±734)mL;A1组与B1组比较,差异无统计学意义(P>0.05);A2组与B2组比较,差异有统计学意义(P<0.05)。结论髁间闭合式膝关节假体对减少TKR术后出血量有一定作用,但不是主要影响因素,术中彻底止血是关键。
Objective To study the influence of close-box and open-box knee prosthesis on postoperative blood loss in patients undergoing total knee replacement(TKR). Methods From June 2005 to December 2006, 108 patients with primary knee osteoarthritis were treated with TKR. Closed-box knee prosthesis was used in 54 patients (Group A), including unilateral (Group A1,n=27)and bilateral (Group A2,n=27). There were 7 males and 47 females, aged 41-76 years; and the disease course was 4-16 years. Open-box knee prosthesis was used in 54 patients(Group B), including unilateral (Group B1,n=27)and bilateral(Group B2,n=27). There were 8 males and 46 females, aged from 59-81 years; and the disease course was 8-26 years. The postoperative blood loss and perioperative blood loss were compared between groups. Results The postoperative blood loss was (890±352), (1 694±528), (1068±386) and(2 065±622) mL in groups A1,A2,B1 and B2,respectively. There was no significant difference between groups A1 and BI(P 〉 0.05). There was significant difference between groups A2 and B2(P 〈 0.05). The total blood loss was (1 095±329), (2 082±594), (1 274±415) and (2 459±734) mL in groups A1, A2, B1 and B2, respectively. There was no significant difference between groups A1 and BI(P 〉 0.05). There was significant difference between groups A2 and B2 (P〈 0.05). Conclusion Closed-box knee prosthesis may play roles on reducing postoperative blood loss. The main influential factor for postoperative blood loss is operation techniques which includes reducing operation time and stanching thoroughly during operation.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2008年第1期9-11,共3页
Chinese Journal of Reparative and Reconstructive Surgery