摘要
目的比较初次全膝关节置换术(total knee arthroplasty,TKA)中可吸收倒刺缝线与常规可吸收缝线缝合切口的临床效果。方法本研究回顾性地选取2017年1月至2018年12月我科收治的80例TKA病人为研究对象,2017年1~12月使用常规可吸收缝线间断缝合关节囊的40例病人纳入对照组,2018年1~12月采用可吸收倒刺缝线连续缝合关节囊的40例病人纳入观察组,比较两组的切口缝合时间、手术时间、拆线时间、住院时间和术后切口并发症发生率等指标的差异,收集两组术后切口疼痛、肿胀、活动度等一般情况及Lysholm膝关节功能评分。结果观察组的切口缝合时间和手术时间分别为(8.02±2.15)min、(65.05±9.15)min,明显少于对照组的(20.45±2.65)min、(94.45±5.28)min,两组相比,差异均有统计学意义(P均<0.05),但两组病人的拆线时间、住院时间比较,差异均无统计学意义(P均>0.05)。观察组的切口总并发症发生率、轻微并发症发生率和严重并发症发生率分别为17.5%、15.0%、2.5%,对照组分别为7.5%、7.5%、0,两组间的总并发症、轻微并发症发生率比较,差异均有统计学意义(χ^(2)=0.187,P=0.014;χ^(2)=0.163,P=0.012)。两组病人术后3周的疼痛视觉模拟量表(visual analogue scale,VAS)评分、关节肿胀程度、膝关节活动度相当,术后12个月的Lysholm膝关节功能评分接近,两组比较,差异均无统计学意义(P均>0.05)。结论倒刺缝线可以满足TKA围手术期对加速康复理念的要求,明显缩短手术时间,提高手术效率,但切口并发症发生率相对增多,对于有伤口适应证的病人合理运用,熟练掌握其缝合技术,以取得最好疗效。
Objective To compare the clinical effectiveness of barbed suture vs.traditional absorbable suture in primary total knee arthroplasty(TKA).Methods A total of 80 TKA patients who were treated in our department from January 2017 to December 2018 were retrospectively selected.Forty patients from January 2017 to December 2017 given traditional absorbable suture to intermittently suture joint capsule were included in the control group,and 40 patients from January 2018 to December 2018 given absorbable barbed suture were included in the observation group.The differences in suture time,operation time,hospitalization time and postoperative incision complications were compared,as well as the differences in general conditions of postoperative incision pain,swelling,range of motion and Lysholm knee function score between the two groups.Results The incision suture time and the operation time in the observation group were(8.02±2.15)min and(65.05±9.15)min respectively,which were significantly shorter than those in the control group[(20.45±2.65)min and(94.45±5.28)min respectively],and the difference was statistically significant(both P<0.05),but there was no significant difference in the suture time and hospitalization time between the two groups(both P>0.05).The total complication rate,minor complication rate and severe complication rate in the observation group were 17.5%,15.0%and 2.5%respectively,and those in the control group were 7.5%,7.5%and 0,respectively.There were significant differences in the incidence of total complications and minor complications between the two groups(χ^(2)=0.187,P=0.014;χ^(2)=0.163,P=0.012).The visual analogue scale(VAS)score,the degree of joint swelling and the range of motion of knee joint at 3rd week after operation,and the Lysholm knee function score at 12th month after operation showed no significant differences between the two groups(P>0.05).Conclusion The barbed suture can meet the requirements of accelerated rehabilitation concept in TKA perioperative period.It significantly shortens the operation time and improves the operation efficiency.However,the relative incision complications increase,so it is necessary to use it reasonably according to the wound indications and master the suture technique skillfully to obtain the best curative effect.
作者
丁云鹏
贾海港
章亚东
DING Yun-peng;JIA Hai-gang;ZHANG Ya-dong(Department of Orthopaedics,Fourth Medical Center,General Hospital of Chinese PLA,Beijing 100048,China)
出处
《骨科》
CAS
2021年第1期24-28,共5页
ORTHOPAEDICS
基金
北京市自然科学基金资助项目(7202199)。
关键词
关节成形术
置换
膝
切口缝合
并发症
倒刺缝线
Arthroplasty,replacement,knee
Incision suture
Complications
Barbed suture
