摘要
背景:近年来膝关节置换是治疗各种晚期骨关节炎较成熟的方法,具有较好的临床疗效,但对于术中是否保留滑膜仍有较大的争议。目的:分析初次全膝关节置换过程中切除滑膜对膝关节骨关节炎患者失血量及膝关节功能的影响。方法:研究纳入60例膝关节骨关节炎患者,其中男25例,女35例,年龄55-70岁,随机分2组治疗,试验组(n=30)在进行全膝关节置换术中切除滑膜,对照组(n=30)在进行全膝关节置换术中不切除滑膜。记录2组手术时间、住院时间、显性失血量、隐性失血量及理论总失血量;术前、术后3d、术后4周及术后12个月时测定目测类比评分;术前、术后4周及术后12个月时测定膝关节HSS评分。结果与结论:(1)试验组的手术时间多于对照组,差异有显著性意义(P<0.05);2组住院时间比较差异无显著性意义(P>0.05);试验组显性失血量、隐性失血量及理论总失血量均多于对照组,差异均有显著性意义(P<0.05);(2)试验组与对照组术前的目测类比评分比较差异无显著性意义,2组术后不同时间点的目测类比评分均较术前显著降低(P<0.05),但2组间比较差异无显著性意义;(3)试验组与对照组术前的膝关节功能HSS评分比较差异无显著性意义,2组术后不同时间点的膝关节功能HSS评分均较术前显著增加(P<0.05),但2组间比较差异无显著性意义;(4)结果表明,在全膝关节置换治疗过程中切除滑膜可明显增加出血量,但并未明显促进膝关节骨关节炎患者膝关节功能的恢复。
BACKGROUND:In recent years,knee arthroplasty is a relatively mature method for the treatment of various advanced osteoarthritis,and has good clinical efficacy.However,there is still a lot of controversy about whether to retain the synovial membrane.OBJECTIVE:To analyze the effect of synovectomy in primary total knee arthroplasty on the blood loss and knee joint function in the patients with knee osteoarthritis.METHODS:Sixty patents with knee osteoarthritis were included,involving 25 males and 35 females,with an age of 55-70 years,and were then randomly divided into two groups(n=30 per group).The patients underwent total knee arthroplasty with(experimental group)or without(control group)synovectomy.The operation time,dominant,hidden and total bold loss,and hospitalization time were recorded.The Visual Analogue Scale scores at baseline,postoperative 3 days,4 and 12 months were detected;the Hospital for Special Surgery scores at baseline,postoperative 4 and 12 months were determined.RESULTS AND CONCLUSION:(1)The operation time,as well as the dominant,hidden and total bold loss in the experimental group were significantly more than those in the control group(P<0.05).There was no significant difference in hospitalization time between two groups(P>0.05).(2)The Visual Analogue Scale scores at beseline and postoperative different time points showed no significant difference between two groups,and the postoperative scores were significantly improved in both groups(P<0.05).(3)No significant difference was found in the Hospital for Special Surgery scores between two groups at baseline and postoperative different time points,and the postoperative scores in both groups were significantly higher than those at baseline(P<0.05).(4)These results imply that the removal of synovial membrane during total knee arthroplasty can induce large amount of blood loss,and has no effect on the knee function in the patients with knee osteoarthritis.
作者
李建锋
崔学文
Li Jian-feng;Cui Xue-wen(School of Medicine,Jiangsu University,Zhenjiang 212013,Jiangsu Province,China;Department of Orthopedics,Changshu No.2 People’s Hospital,Changshu 215500,Jiangsu Province,China;Department of Orthopedics,the Affiliated Hospital of Jiangsu University,Zhenjiang 212001,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第11期1659-1664,共6页
Chinese Journal of Tissue Engineering Research
