摘要
背景:全膝关节置换术后切口愈合不良是一种常见并发症,严重影响术后康复及患者满意度。目的:分析全膝关节置换术后切口愈合不良的危险因素。方法:回顾性分析2014年6月至2016年6月198例行单侧初次全膝关节置换术患者的临床资料。分析年龄、性别、"鸡尾酒"应用、原发病、糖尿病、高血压、术中止血带使用时间、体重指数(BMI)等因素对切口愈合不良的影响。结果:术后切口愈合不良13例,发生率为6.5%。Logistic回归分析显示糖尿病(OR=13.58,95%CI:2.35~78.65,P=0.004)、止血带时间偏长(OR=1.03,95%CI:1.01~1.05,P=0.047)、类风湿性关节炎(OR=12.53,95%CI:1.82~86.14,P=0.010)及肥胖(OR=12.98,95%CI:2.01~82.23,P=0.009)患者切口愈合不良的发生概率明显偏高,差异有统计学意义;而年龄(OR=1.01,95%CI:0.93~1.09,P=0.792)、性别(OR=2.30,95%CI:0.37~14.4,P=0.376)、高血压(OR=0.51,95%CI:0.09~2.96,P=0.451),"鸡尾酒"应用(OR=0.79,95%CI:0.23~2.77,P=0.714)的切口愈合不良发生率均无显著差异,不具有统计学意义。结论:类风湿性关节炎、糖尿病、肥胖及术中止血带使用时间较长是发生全膝关节置换术后切口愈合不良的危险因素。
Background： Impaired incision healing, a common complication after total knee arthroplasty（TKA）, plays negative roles in postoperative rehabilitation and patients＇ satisfaction. Objective： To analyze risk factors of impaired incision healing after TKA. Methods： A total of 198 patients undergoing primary unilateral TKA between June 2014 and June 2016 were retrospectively analyzed. The age, gender, cocktail application, etiology, diabetes, hypertension, tourniquet duration and body mass index（BMI） were analyzed to find risk factors of postoperative impaired incision healing in TKA. Results：The incidence of postoperative impaired incision healing in TKA was 6.5%（13/198）. Logistic regression analysis showed that diabetes（OR=13.58, 95% CI： 2.35-78.65, P=0.004）, long time of tourniquet use（OR=1.03, 95% CI： 1.01-1.05, P=0.047）, rheumatoid arthritis（OR=12.53, 95% CI： 1.82-86.14, P=0.010） and obesity（OR=12.98, 95% CI： 2.01-82.23, P=0.009） were related to a high incidence of postoperative impaired incision healing. However, gender（OR=2.30, 95% CI：0.37-14.4, P=0.376）, age（OR=1.01, 95% CI： 0.93-1.09, P=0.792）, cocktail application（OR=0.79, 95% CI： 0.23-2.77, P=0.714） and hypertension（OR=0.51, 95%CI： 0.09-2.96, P=0.451） were not the risk factors of impaired incision healing. Con Conclusions： Rheumatoid arthritis, diabetes, obesity and long time of tourniquet using are risk factors related to impaired incision healing after TKA.
作者
常梦寒
张卫国
陈珍珍
段梦霜
高超
殷远超
CHANG Menghan;ZHANG Weiguo;CHEN Zhenzhen;DUAN Mengshuang;GAO Chao;YIN Yuanchao(Department of Orthopedics, The First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning, China)
出处
《中华骨与关节外科杂志》
2018年第1期11-14,共4页
Chinese Journal of Bone and Joint Surgery
关键词
膝关节
人工关节
切口愈合
Knee Joint
Joint Prosthesis
Wound Healing
