可吸收倒刺缝合线在人工全膝关节置换术中应用的病例对照研究  

Case-control study on the biodegradable barbed sutures in total knee arthroplasty

作　　者：张卓[1] 周勇刚[1] 林峰[1] 任鹏[1] 柴伟[1] 李睿[1] 倪明[1] 陈继营[1] ZHANG Zhuo ZHOU Yong-gang LIN Feng REN Peng CHAI Wei LI Rui NI Ming CHEN Ji-ying(Department of Orthopaedics, General Hospital of PLA , Beijing 100853, China)

机构地区：[1]中国人民解放军总医院骨科,北京100853

出　　处：《中国骨伤》2016年第9期809-813,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的 ：对比使用倒刺缝合线和传统缝线在人工全膝关节置换术中切口关闭的临床应用效果。方法 ：自2013年9月至2014年6月,选取膝骨性关节炎患者116例,分为研究组（T）和对照组（C）。研究组68例,平均年龄（65.26±8.50）岁,其中女58例,男10例;对照组48例,平均年龄（64.43±10.08）岁,其中女41例,男7例。所有患者接受单侧初次人工全膝关节置换术。研究组选用可吸收倒刺缝合线连续缝合关节囊,对照组选用可吸收抗菌薇乔连续锁边缝合关闭关节囊。所有患者采用2-0可吸收抗菌薇乔缝合皮下组织,皮钉闭合皮肤。对两组患者的缝合时间、术后3 d切口并发症、术后住院时间及术后特殊事件进行统计比较。结果 ：研究组平均缝合时间（21.65±4.11）min（15～32 min）,对照组平均缝合时间（31.83±4.55）min（22～45 min）,研究组低于对照组（P=0.000）;切口相关并发症发生率研究组30.88%（21/68）,对照组20.83%（10/48）,两组差异无统计学意义（χ^2=1.451,P=0.161）;研究组术后平均住院时间（5.68±1.36）d,对照组（5.46±1.29）d,两组差异无统计学意义（P=0.407）。结论 ：使用倒刺缝合线应用于人工全膝关节置换术,能够明显缩短手术缝合时间,但需要更为细致的缝合方法和谨慎的术后观察。切口并发症的发生对手术效果及患者住院时间无明显影响。Objective：To compare with the clinical outcomes of barbed sutures and routine sutures in total knee arthroplasty.Methods：From September 2013 to June 2014,total 116 patients with knee osteoarthritis（OA） who underwent primary unilateral total knee arthroplasty（TKA） were enrolled in the series.There were 68 patients in the test group（T）,including 58 females and 10 males,with an average age of（65.26±8.50） years old.There were 48 patients in the control group（C）,including 41 females and 7 males,with an average age of（64.43±10.08） years old.Absorbable barbed sutures were selected in test group for capsule continuous closure,while coated absorbable VICRYL Plus Sutures were used in control group for continuous hemstick closure.Coated VICRYL Plus Sutures and skin stapler were selected for subcutaneous and skin closures respectively in both groups.Closure time,wound associated complications and postoperative hospital stay as well as special events were recorded,compared and analyzed.Results：The mean closure time in test group was shorter,which were（21.65±4.11） minutes（ranged,15 to 32 minutes）,comparing with（31.83±4.55） minutes in control group（ranged,22 to 45 minutes）,with a significant difference（P=0.000）.No significant differences were found in wound associated complications（χ^2=1.451,P=0.161） or mean postoperative hospital stay（T：5.68±1.36,C：5.46±1.29,P=0.407）.However,ratio of complications was higher in test group（21/68 versus 10/48）,and the most commom complication was continuous effusion.Conclusion：Barbed suture can significantly shorten the closure time,but leads to a higher incidence of wound complications,therefore the method requires more professional technique and more cautious postoperative observation.

关 键 词：关节成形术 置换 膝 缝合技术 手术后并发症 病例对照研究 

分 类 号：R687.4[医药卫生—骨科学]