普里林线与丝线缝合对全膝关节置换术后切口愈合的影响  

Effects of prolene and silk sutures on wound healing after total knee arthroplasty

作　　者：滕元君[1] 郭来威 吴萌[1] 杨凯[1] 赵良功[1] 盛晓赟[1] 徐立虎[1] 张成俊[1] 夏亚一[1,2] Teng Yuanjun Guo Laiwei Wu Meng Yang Kai Zhao Lianggong Sheng Xiaoyun Xu Lihu Zhang Chengjun Xia Yayi(Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, China Orthopaedics Key Laboratory of Gansu Province, Lanzhou 730030, China)

机构地区：[1]兰州大学第二医院骨科,730030 [2]甘肃省骨关节疾病研究重点实验室,兰州730030

出　　处：《中华关节外科杂志（电子版）》2017年第3期82-85,共4页Chinese Journal of Joint Surgery(Electronic Edition)

摘　　要：目的观察普里林线(Prolene线)与普通丝线缝合对全膝关节置换(TKA)手术切口愈合的影响。方法选取2014年07月至2015年07月在兰州大学第二医院骨科行TKA手术的82例患者,采用随机数字表将其随机分为普里林线缝合组(39例)与丝线缝合组(43例);平均年龄(61±4)岁,男性22例,女性60例。收集主要指标:浅表与深层感染例数、术后切口红肿例数;次要指标:切口缝合时间、住院时间、材料费用、5级满意度自评分数、术后第1、3、7天视觉模拟评分(VAS)。采用SPSS 19.0软件对资料进行统计分析,浅表与深层感染例数、术后切口红肿例数组间比较采用卡方检验;切口缝合时间、住院时间、5级满意度自评分数、术后第1、3、7天VAS评分的组间比较采用独立样本t检验。结果普里林线缝合组患者出现切口红肿的概率15.4%(6/39)低于丝线缝合组46.5%(20/43),组间差异有统计学意义(x^2=4.87,P<0.05);普里林线缝合组患者对切口自评满意度(4.4±1.2)分高于丝线缝合组(3.8±1.2)分,组间差异有统计学意义(t=2.26,P<0.05);普里林线缝合组缝合时间(8.2±2.5)分高于丝线缝合组(3±1.9)分,组间差异有统计学意义(t=10.66,P<0.05),且普里林线缝合组的材料费用(80元)高于丝线缝合组(20元);普里林线缝合组与丝线缝合组在浅表及深层感染率、术后1、3、7 d VAS评分、住院时间方面差异无统计学意义(P>0.05)。结论普里林线可以安全的应用于缝合TKA手术切口,适合于对手术切口外观要求较高者使用。Objective To observe the effect of prolene suture and suture on the wound healing of total knee arthroplasty. Methods A total of 82 patients （22 males and 60 females） who underwent total knee arthroplasty （TKA） operation from July 2014 to July 2015 at the Second Hospital of Lanzhou University were randomly divided into two groups using a random number table： the prolene group （39 cases） and the silk group （43 cases）, with the average age of （61 ±4） years. Main indicators were collected as follows： the cases of superficial and deep infection, the cases of postoperative incision swelling; secondary indicators included： suture time of incision, hospitalization time, material cost, the satisfaction scale, visual analogue scale （VAS） score at the postoperative 1^st, 3^rd and 7^th day. Results The probability of incision swelling was 15.4% （6/39） in the prolene group, lower than that [ 46. 5% （20/43） ] in the silk group, with significant difference between the two groups （χ^2 = 4. 87, P 〈 0. 05 ） ; the patients self-evaluation satisfaction in the prolene group [ （4. 4 ± 1.2 ） ] was higher than that in the silk group [ （3.8± 1.2 ） ], with significant difference between the two groups （ t = 2.26, P 〈 0. 05 ） ; the suture time in the prolene group [ （8.2 ± 2. 5 ） min ] was longer than that in the silk group [ （ 3 ± 1.9） min], with significant difference between the two groups （t = 10. 66, P 〈0, 05）, and the material cost in the prolene group （80 yuan） was higher than that in the silk group （20 yuan）. There was no significant difference in the superficial and deep infection rates, postoperative VAS score at postoperative 1^st, 3^rd and 7^th day, nor the hospitalization time, between the two groups （P 〉 0.05）. Conclusion Prolene suture can be safely used in the incision suture progress of the total knee arthroplasty, and it is suitable for the patients with higher requirements of appearance of the surgical incision.

关 键 词：聚丙烯类 缝线 关节成形术 置换 膝 外科伤口 伤口愈合 

分 类 号：R687.4[医药卫生—骨科学]