摘要
目的探讨关节镜治疗半月板损伤围手术期膝关节腔内血肿的危险因素。方法前瞻性观察2020年1—10月在我科行关节镜手术治疗的87例膝关节半月板损伤病人,根据术后3 d膝关节积血量分为血肿组(>20 mL)25例和正常组(≤20 mL)62例。收集病人性别、年龄、体质量指数(BMI)、损伤原因、疼痛时间、手术时间、玻璃酸钠注射、弹力绷带加压、持续性关节被动活动(CPM)次数、负重时间、伤口缝合时机等基本资料,采用SPSS 23.0软件对数据进行单因素分析,将单因素分析有统计学意义的因素纳入二分类Logistic回归分析围手术期膝关节腔内血肿的独立危险因素。结果单因素分析显示,两组间年龄、手术时间、玻璃酸钠注射、弹力绷带加压、CPM次数、缝合伤口时机比较,差异均具有统计学意义(t=2.738、3.928,χ^(2)=5.014~10.473,P<0.05)。二分类Logistic回归分析显示,手术时间延长(OR=1.030,P=0.014)、无弹力绷带加压(OR=3.370,P=0.048)、CPM次数>4次(OR=3.615,P=0.036)和松止血带前缝合伤口(OR=3.860,P=0.029)与关节镜术后膝关节腔内血肿存在明显相关性。结论手术时间延长、未经弹力绷带加压、CPM次数>4次和松止血带前缝合伤口是关节镜术后膝关节腔内血肿的独立危险因素。
Objective To investigate the risk factors for knee joint hematoma in the perioperative period of arthroscopy for the treatment of meniscus injury.Methods A prospective observational study was performed for 87 patients with knee meniscus injury who underwent arthroscopic surgery in our department from January to October 2020,and according to the volume of knee joint hemorrhage on day 3 after surgery,they were divided into hematoma(>20 mL)group with 25 patients and normal(≤20 mL)group with 62 patients.Related information was collected,including sex,age,body mass index,cause of injury,duration of pain,time of operation,sodium hyaluronate injection,elastic bandage compression,continuous passive movement(CPM)times,weight-bearing time,and timing of wound suture.SPSS 23.0 software was used to perform the univariate analysis of data,and then the factors with statistical significance were included in the binary Logistic regression analysis to investigate the indepen-dent risk factors for knee joint hematoma in the perioperative period.Results The univariate analysis showed that there were significant differences between the two groups in age,time of operation,sodium hyaluronate injection,elastic bandage compression,CPM times and timing of wound suture(t=2.738,3.928;χ^(2)=5.014-10.473;P<0.05).The binary Logistic regression analysis showed that time of operation(OR=1.030,P=0.014),absence of elastic bandage compression(OR=3.370,P=0.048),CPM>4 times(OR=3.615,P=0.036),and wound suture before loosening of tourniquet(OR=3.860,P=0.029)were significantly associated with knee joint hematoma after arthroscopic surgery.Conclusion Prolonged time of operation,absence of elastic bandage compression,CPM>4 times,and wound suture before loosening of tourniquet are independent risk factors for knee hematoma after arthroscopic surgery.
作者
韩增帅
宋文联
李淳朴
赵夏
张益
于腾波
HAN Zengshuai;SONG Wenlian;LI Chunpu;ZHAO Xia;ZHANG Yi;YU Tengbo(Department of Sports Medicine, The Affiliated Hospital of Qingdao University, Qingdao 266100, China)
出处
《青岛大学学报（医学版）》
2021年第6期865-869,共5页
Journal of Qingdao University(Medical Sciences)
基金
山东省自然科学基金资助项目(ZR2019MH097)。
关键词
关节镜检查
胫骨半月板损伤
围手术期
膝关节
血肿
危险因素
arthroscopy
tibial meniscus injuries
perioperative period
knee joint
hematoma
risk factors
