倒刺缝线在膝关节置换术缝合中的应用  

Application of Knot-free Barb Suture in Deep Tissue Suture of Knee Replacement

作　　者：杨生森 张晨[2] 姚羽[3] 董毅[1] 陈德胜[1] Yang Shengsen;Zhang Chen;Yao Yu(Department of Orthopedics,General Hospital of Ningxia Medical University,Ningxia 750004,China)

机构地区：[1]宁夏医科大学总医院骨一科,银川750004 [2]宁夏医科大学研究生院,银川750004 [3]南通大学附属医院骨科,226021

出　　处：《医学研究杂志》2021年第2期117-121,共5页Journal of Medical Research

基　　金：宁夏回族自治区卫生健康委员会重点研究基金资助项目(19);宁夏医科大学校级基金资助项目(XM2020182)。

摘　　要：目的研究倒刺缝线在膝关节置换术缝合中的应用对术后康复的影响。方法将96例因膝关节骨性关节炎行全膝关节置换的患者采用数字表法随机分为观察组(n=48)和对照组(n=48),观察组使用0号倒刺缝线连续缝合关节囊,2号倒刺缝线连续缝合皮下组织层。对照组使用传统1号可吸收薇乔缝线间断缝合关节囊,0号薇乔间断缝合皮下组织层。对比两组缝合时间、术中出血量、切口渗漏情况,检测两组术后不同时间红细胞沉降率及C反应蛋白,采用膝关节HSS及AKS评分对术后膝关节功能进行评分并记录两组术后并发症发病情况。结果两组患者手术切口长度比较差异无统计学意义。观察组在缝合时间、术中失血量以及出现渗漏患者数量均明显少于对照组(P值分别为0.001、0.034、0.041)。两组术前、术后1天、术后1个月ESR、CRP变化及两组患者术前、术后1周、术后1个月、术后3个月膝关节HSS评分和AKS评分比较差异无统计学意义。观察组术后并发症发生率为4.73%,对照组为27.18%(P=0.024)。结论在人工全膝关节置换术中使用倒刺缝线连续缝合深部组织,可明显缩短TKA手术的时间,减少并发症的发生,且不影响患者术后膝关节功能恢复,临床疗效安全。Objective To study the effect of barbed suturesin the suture of knee joint replacement surgery on postoperative rehabilitation.Methods Ninety six patients were divided into observation group(48 cases)and control group(48 cases).In observation group,0 barb suture line was used to suture the joint capsule continuously,and 2 barb suture line was used to suture the subcutaneous tissue layer continuously.In the control group,the conventional no.1 absorbable Viagra suture was used for intermittent suture of the joint capsule,and no.0 Viagra suture was used for intermittent suture of the subcutaneous tissue layer.The suture time,intraoperative blood loss,incision,erythrocyte sedimentation rate and C-reactive protein were detected at different postoperative times in the two groups.Knee joint function was scored using HSS and AKS rating scale,and the incidence of postoperative complications in the two groups was recorded.Results The suture time,intraoperative blood loss and the number of patients with leakage in the observation group were significantly less than or less than those in the control group(P=0.001,P=0.034,P=0.041).There were no significant differences in ESR and CRP between the two groups before surgery,1 day after surgery,1 month after surgery,and HSS and AKS scores of the knee before surgery,1 week after surgery,1 month after surgery,and 3 months after surgery.The incidence of postoperative complications was 4.73%in the observation group and 27.18%in the control group(P=0.024).Conclusion Continuous suture of deep tissue with barbs in total knee arthroplasty can significantly shorten the time of TKA operation and reduce the occurrence of complications,without affecting the postoperative recovery of knee function,and the clinical efficacy is safe.

关 键 词：膝关节骨性关节炎 人工全膝关节置换术 倒刺缝线 加速康复外科 

分 类 号：R684.3[医药卫生—骨科学]