摘要
背景:大量研究表明计算机辅助导航全膝关节置换(TKA)具有传统手术不可比拟的许多优势,如下肢力线精确、软组织平衡良好、手术创伤小及并发症少等,但对于计算机辅助导航TKA术后下肢深静脉血栓形成(DVT)发生率的研究尚少。目的:比较计算机辅助导航与传统TKA术后下肢DVT发生率的差异。方法:回顾性分析2010年9月至2011年8月行初次TKA的53例58膝。其中导航组,即行计算机辅助导航TKA治疗23 例 26 膝,年龄 42～82 岁,平均 67.3 岁;传统组,即行传统 TKA 治疗 30 例 32 膝,年龄 53～78 岁,平均 67.1 岁。根据术后3～5 d 行下肢深静脉造影检查结果比较两组 DVT 的发生率,并比较两组的手术时间、止血带时间及压力、术中出血量与术后引流量总和的差异。结果:导航组和传统组术后DVT发生率分别为8.7%和36.7%,相比较有统计学意义(P=0.015);导航组和传统组手术时间分别为(146.2±21.3)min和(110.0±18.0)min,相比较有统计学差异(P<0.001);术中出血量与术后引流量总和分别为(987.1±441.9)ml和(1250.0±422.5)ml,相比较有统计学差异(P=0.025);止血带时间分别为(50.3±17.5)min和(45.9±15.4)min,止血带压力分别为(257.7±20.7)mmHg 和(255.9±18.1)mmHg,相比较均无统计学差异(P=0.314 和 0.732)。结论:计算机辅助导航TKA可降低术后下肢DVT的发生率。
Background： Many studies concluded that total knee arthroplasty （TKA） with computer-assisted navigation has some advan-tages over conventional surgery, such as better mechanical axes, better softtissue balance, less trauma and less complica-tions. However, there have been few studies about the incidence of deep venous thrombosis （DVT） in lower extremity after TKA with computer-assisted navigation. Objective： To compare the incidence of DVT in lower extremity after TKA with and without computer-assisted navigation. Methods： Fifty-three patients （58 joints）, who underwent primary TKA at our center from September 2010 to August 2011, were recruited to this retrospective study.Twenty-three patients （26 joints） underwent TKA via computer-assisted navigation in a navigated group, with an average age of 67.3 years （range, 42-82 years）. Thirty patients （32 joints） underwent conven-tional TKA in a conventional group, with an average age of 67.1 years （range, 53-78 years）. The incidence of the lower ex-tremity DVT was measured by anterograde venography within the first 3-5 days after TKA. The operation time, the tourni- quet time and pressure, and the total volume of intraoperative blood loss and postoperative drainage were compared be- tween the two groups. Results： The incidence of the lower extremity DVT in the navigated group and the conventional group was 8.7% and 36.7%, respectively, and the difference between the two groups was statistically significant （P=-0.015）. The operation time was （146.2±21.3）min in the navigated group and （110.0±18.0）min in the conventional group （P〈 0.001 ）. The total volume of in-traoperative blood loss and postoperative drainage was （987.1±441.9）ml in the navigated group and （1250.0±422.5）ml in the conventional group （P=0.025）. Nevertheless, there was no statistical significance between the two groups in the tourni-quet time （[50.3±17.5]min vs [45.9±15.4]min, P=-0.314） and the tourniquet pressure （[257.7±20.7]mmHg and [255.9±18.1]mmHg, P=0,732）. Conclusions： The incidence of the lower extremity DVT is significantly reduced after TKA with computer-assisted naviga-tion in contrast to that with conventional procedures.
出处
《中国骨与关节外科》
2013年第1期13-16,12,共5页
Chinese Journal of Bone and Joint Surgery
基金
国家自然科学基金面上项目(30973046)
关键词
关节成形术
置换
膝
计算机辅助导航
血栓
arthroplasty, replacement, knee
computer-assisted navigation
thrombosis
