摘要
背景:目前关于关节置换的文献报道目前大多侧重于其远期并发症的原因与对策,而对术后近期并发症如伤口持续渗出和延迟愈合的原因关注甚少。有高血压病的患者行髋关节置换后伤口持续渗出和延迟愈合的发生率是否高于血压正常患者国内外尚无相关报道。目的:明确人工股骨头置换后伤口持续渗出和延迟愈合与高血压之间的关系。方法:回顾性分析205例老年股骨颈骨折患者资料,所有患者均接受人工股骨头置换术治疗;根据《中国高血压防治指南2010》中的高血压诊断标准分为高血压组和对照组,主要比较两组患者关节置换中失血量、置换后失血量、伤口持续渗出时间、伤口裂开和伤口延迟愈合发生率是否有差异,分析高血压与伤口渗出和延迟愈合的关系。结果与结论:(1)高血压组平均收缩压为153.55 mm Hg,对照组为128.82 mm Hg,差异有显著性意义(P<0.05);(2)两组患者年龄、性别、关节置换前MNA-SF营养风险评分、合并糖尿病例数、体质量指数,以及关节置换中和置换后失血量差异均无显著性意义(P>0.05);(3)高血压组患者伤口持续渗出时间为4.03 d,对照组为2.08 d,差异有显著性意义(P<0.05);(4)高血压组患者的伤口延迟愈合发生率明显高于对照组(P<0.05);(5)结果说明,高血压能够增加关节置换术后伤口持续渗出和延迟愈合发生率的风险,是伤口延迟愈合的重要影响因素之一。
BACKGROUND： At present, most of the literature on joint replacement focus on the causes and countermeasures of long-term complications, but seldom focuses on causes of postoperative short-term complications, such as wound exudation and delayed union. Whether the incidence of sustained exudation and delayed wound healing in patients with hypertension after hip replacement is higher than that in patients with normal blood pressure is not reported at present.OBJECTIVE： To identify the correlation of hypertension with persistent wound exudation and delayed wound healing in patients after femoral head replacement.METHODS： Data of 205 elderly patients with femoral neck fractures were retrospectively analyzed. All patients underwent femoral head replacement. In accordance with the hypertension diagnostic criteria of 2010 Chinese Guidelines for the Management of Hypertension, patients were divided into hypertension group and control group.Intraoperative blood loss, postoperative blood loss, the days of prolonged wound exudation, the wound dehiscence, and the prevalence of delayed wound healing were compared between the two groups. Then, we analyzed the relationship of hypertension with wound exudation and delayed wound healing.RESULTS AND CONCLUSION： （1） The average systolic blood pressures were 153.55 mmHg and 128.82 mmHg in the hypertension and control groups, respectively （P 〈 0.05）. （2） No significant difference in age, gender, MNA-SF score, diabetes, body mass index, intraoperative blood loss, and postoperative blood loss was found between the two groups （P 〉 0.05）. （3） The time of persistent wound exudation was 4.03 days and 2.08 days in the hypertension group and control group, respectively （P 〈 0.05）. （4） The prevalence of delayed wound healing was significantly higher in the hypertension group than that in the control group （P 〈 0.05）. （5） Hypertensive patients had a higher risk of prolonged wound exudation and delayed healing than their normotensive counterparts, and the hypertension is one of the important influence factors for delayed wound healing.
出处
《中国组织工程研究》
CAS
北大核心
2017年第15期2331-2335,共5页
Chinese Journal of Tissue Engineering Research
基金
南京市科技计划项目(201503007)
南京军区科技创新项目(15ZD020)~~
