前交叉韧带重建术后膝关节引流量的影响因素分析  

Influencing Factors of Intraarticular Drainage Output Following Anterior Cruciate Ligament Reconstruction

作　　者：施海飞 李娜[1] 张文晶 张頔[1] 郑峒 Shi Haifei;Li Na;Zhang Wenjing;Zhang Di;Zheng Tong(Operating Theater,Beijing Jishuitan Hospital,Beijing 100035,China;Sports Medicine Department,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院手术室,北京100035 [2]北京积水潭医院运动损伤科,北京100035

出　　处：《中国运动医学杂志》2021年第3期186-192,共7页Chinese Journal of Sports Medicine

摘　　要：目的:探究前交叉韧带(anterior cruciate ligament,ACL)重建术后24小时膝关节引流量的影响因素。方法:对2019年10月至2020年6月连续收治的ACL损伤并接受ACL重建术的99例患者进行回顾性研究。根据术后24小时关节内引流量将患者分为两组:研究组引流量>100 ml,46例;对照组引流量≤100 ml,53例。比较组间人口学数据、病史资料和术中情况,术中情况包括:骨隧道直径、是否行髁间窝成型、半月板情况、手术时长及术中出血量。通过多元Logistic回归分析引流量>100 ml的危险因素。结果:入选患者男78例,女21例,年龄29.3±8.6岁(16~49岁),体质指数(BMI)25.5±3.2 kg/m^(2)。术后24小时平均引流量为112.9±71.0 ml。术后24小时引流量>100 ml的独立危险因素为男性(OR=3.887,P=0.035)、骨隧道直径>8 mm(OR=3.291,P=0.037)和行髁间窝成型(OR=3.332,P=0.016)。半月板损伤时,研究组行半月板部分切除的患者比例高于对照组(61.8%vs 30.3%,χ2=6.668,P=0.010)。结论:男性、骨隧道直径>8 mm和行髁间窝成型是ACL重建术后引流量增多的独立危险因素,行半月板部分切除导致引流量进一步增加,术后留置关节内引流对存在上述特征的患者更为必要。Objective To explore the influencing factors of intraarticular drainage output within 24 hours following the anterior cruciate ligament(ACL)reconstruction.MethodsTotally 99 patients diag-nosed as ACL injury and undergoing the ACL reconstruction between October 2019 and June 2020 were studied retrospectively.According to the intraarticular drainage output within 24 hours followingACL reconstructions,patients were allocated into a study group(output>100 ml,n=46)and a controlgroup(output≤100 ml,n=53).Demographic data,medical history,and intraoperative findings werecompared between the two groups.Intraoperative findings included the tunnel diameter,receiving notch-plasty(or not),meniscal status,operative time,and intraoperative blood loss.Risk factors of drainageoutput>100 ml were identified using the multivariate logistic regression analysis.ResultsTotally 78 males and 21 females were included,with an average age of 29.3±8.6 years(range 16~49)and aver-age body mass index(BMI)of 25.5±3.2 kg/m^(2).The mean output of intraarticular drainage within 24 hours following ACL reconstructions was 112.9±71.0 ml.The sex of male(OR=3.887,P=0.035),tun-nel diameter>8 mm(OR=3.291,P=0.037),and receiving notchplasty(OR=3.332,P=0.016)were foundto be the independent risk factors of drainage output>100 ml.For patients with meniscal lesions,sig-nificantly more patients of the study group underwent partial meniscectomies than the control group(45.6%vs 18.9%,χ2=6.668,P=0.010).ConclusionMale,the tunnel diameter>8 mm,and receivingnotchplasty are independent risk factors for increased output of intraarticular drainage following ACL re-constructions.Partial meniscectomies further increase the output of intraarticular drainage.Therefore,in-traarticular drainage after ACL reconstructions is more necessary for patients with higher risks.

关 键 词：前交叉韧带 引流 危险因素 关节镜 病例对照研究 

分 类 号：R687.4[医药卫生—骨科学]