初次全膝关节置换术加速康复:倒刺线缝合关节囊的应用  

Primary Total Knee Arthroplasty under Enhanced Recovery after Surgery:Capsular Closure with Barbed Suture

作　　者：袁宇飞 张存[1] 李冠军[1] 任志鑫[1] 李艳宝[1] 李晓东[1] 刘炳智[1] 苗洁[1] YUAN Yu-fei;ZHANG Cun;LI Guan-jun;REN Zhi-xin;LI Yan-bao;LI Xiao-dong;LIU Bing-zhi;MIAO Jie(The Fifth Department of Orthopedics, Handan Central Hospital, Handan 056001, China)

机构地区：[1]邯郸市中心医院骨五科,邯郸056001

出　　处：《科学技术与工程》2021年第18期7500-7504,共5页Science Technology and Engineering

摘　　要：为评价在加速康复理念下初次全膝关节置换术中应用倒刺线缝合关节囊较可吸收线的优势,回顾性分析2018年7月至2019年7月邯郸市中心医院骨五科行初次全膝关节置换术的85例患者,其中倒刺线组41例、可吸收线组44例,比较两组在切口缝合时间、切口并发症、术后关节功能方面的差异。结果表明:倒刺线组关节囊缝合时间、总缝合时间与可吸收线组相比显著缩短,差异有统计学意义(P=0.003、P=0.035);倒刺线组皮下缝合时间、皮肤缝合时间与可吸收线组相比,差异无统计学意义(P=0.100、P=0.740);倒刺线组切口皮下血肿率低于可吸收线组,倒刺线组切口并发症发生率低于可吸收线组,差异无统计学意义(P=1.0);倒刺线组术后膝关节活动度与可吸收线组相比,差异无统计学意义(P=0.961);术后3月和末次随访两组KSS(Knee Society score)(膝关节协会评分)临床评分及功能评分均较术前明显改善,差异有统计学意义(P<0.05),两组组间及组内比较差异无统计学意义(P>0.05)。倒刺线缝合关节囊手术时间短,切口并发症少,术后关节功能良好,有利于加速康复,推荐使用。To evaluate the advantage of barbed suture to traditional suture technique in capsular closure of primary total knee arthroplasty under enhanced recovery after surgery,a total number of 85 patients for primary total knee arthroplasty in the Fifth Department of Orthopedics in Handan Central Hospital form July 2018 to July 2019 were enrolled in this retrospective analysis.The patients were divided into two groups:barbed suture group(n=41)and absorbable suture group(n=44).The closure time of the incision,post-operative complications of the incison and post-operative function of the knee of the two groups were compared to evaluate the differences of the clinical results.The results show as follows.The capsular closure time and global closure time of the barbed suture group is significantly shorter than that of the absorbable suture group,indicating significantly statistical differences(P=0.003、P=0.035).The subcutaneous and skin closure time of the barbed suture group compared with the absorbable suture group are no significantly statistical differences(P=0.100、P=0.740).The rate of incision subdermal hematoma of the barbed suture group is lower than that of absorbable suture group.The incidence rate of complications of incision of the barbed suture group is lower than that of the absorbable suture group which has no significantly statistical differences(P=1.0).The post-operative range of motion of the knee of the barbed suture group is no significantly statistical differences with the absorbable suture group.The KSS(Knee Society score)clinical score and function score at three months after surgery and the last follow-up are significantly improved before surgery respectively,and the difference was statistically significant(P<0.05).There is no statistically significant differences between the two groups and inside the two groups(P>0.05).Barbed suture is associated with shorter closure time in capsular closure,less post-operative complications of incision and excellent post-operative function of the knee which contri

关 键 词：加速康复 初次全膝关节置换术 关节囊 倒刺线 膝关节协会评分(Knee Society score KSS) 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]