骨关节炎患者全膝关节置换术治疗中骨水泥封堵股骨髓腔对失血量的影响  

Effects of bone cement blocking the femoral medullary cavity on blood loss during total knee arthroplasty in patients with osteoarthritis

作　　者：彭超 庞巨涛 李文哲 尚瑞松 张新虎 PENG Chao;PANG Ju-tao;LI Wen-zhe(Department of Orthopedics,Hengshui People's Hospital,Hengshui Hebei 053000,China)

机构地区：[1]衡水市人民医院骨科,河北衡水053000

出　　处：《临床和实验医学杂志》2022年第22期2418-2421,共4页Journal of Clinical and Experimental Medicine

基　　金：2021年度河北省医学科学研究课题计划项目(编号:20210322)。

摘　　要：目的研究骨关节炎患者全膝关节置换术(TKA)治疗中骨水泥封堵股骨髓腔对失血量的影响。方法采用回顾性分析方法,研究对象为2020年月1月至2021年6月衡水市人民医院的122例因骨关节炎首次接受单侧TKA的患者,根据不同股骨髓腔封堵方式分为研究组(n=54)与对照组(n=68);对照组选取自体截骨块制作的塞子对股骨髓腔口予以填塞,研究组在对照组基础上选取面团期骨水泥对残存股骨髓腔裂隙予以封堵。比较两组患者的显性失血量、股骨截骨厚度、手术时间、下肢深静脉血栓(DVT)发生率、异体输血率、麻醉方式与术后不同时间段(第1天、第2天、第3天、第7天、第14天)隐性失血量。结果两组患者显性失血量、股骨截骨厚度、手术时间、麻醉方式、下肢DVT发生率比较,差异均无统计学意义(P>0.05);研究组患者异体输血率(14.81%)明显低于对照组(35.29%),差异有统计学意义(P<0.05)。两组患者术后第1天、第2天隐性失血量比较,差异均无统计学意义(P>0.05);研究组患者术后第3天、第7天、第14天隐性失血量分别为(376±64)、(420±57)、(542±64)mL,均显著低于对照组[(419±78)、(499±71)、(626±76)mL],差异均有统计学意义(P<0.05)。结论骨关节炎患者TKA治疗中骨水泥封堵股骨髓腔可有效降低术后隐性失血量,减少异体输血。Objective To study the effect of bone cement sealing of the femoral medullary cavity on blood loss in patients with osteoarthritis during total knee arthroplasty(TKA).Methods Using a retrospective analysis method,the research subjects were 122 patients who received unilateral TKA for the first time due to osteoarthritis in Hengshui Peoples Hospital from January 2020 to June 2021.They were divided into study groups according to different femoral medullary cavity closure methods(n=54)and control group(n=68);the control group selected plugs made of autologous osteotomy blocks to fill the femoral medullary cavity,and the research group selected dough-stage bone cement to seal the remaining femoral medullary cavity fissures on the basis of the control group.Blocking.The obvious blood loss,femoral osteotomy thickness,operation time,incidence of lower extremity deep vein thrombosis(DVT),allogeneic blood transfusion rate,anesthesia method and different postoperative time periods hidden blood loss(day 1,day 2,day 2,3 days,7 days,14 days)were compared between the two groups.Results There was no statistically significant difference in the amount of apparent blood loss,femoral osteotomy thickness,operation time,anesthesia method,and the incidence of lower extremity DVT between the two groups(P>0.05).The rate of allogeneic blood transfusion in the study group(14.81%)was significantly lower than that in the control group(35.29%),and the difference was statistically significant(P<0.05).There was no statistical ly significant difference in the hidden blood loss between the two groups on the first day and the second day after the operation(P>0.05);the hidden blood loss of the patients in the study group on the 3rd,7th,and 14th days after the operation were(376±64),(420±57),(542±64)mL,which were significantly lower than those in the control group[(419±78),(499±71),(626±76)mL],and the differences were statisti cally significant(P<0.05).Conclusion Bone cement blocking the femoral medullary cavity during TKA treatment in patien

关 键 词：骨关节炎 全膝关节置换术 骨水泥 股骨髓腔 封堵 失血量 

分 类 号：R687.4[医药卫生—骨科学]