全膝关节表面置换术经典切口与改良切口术后切口外侧皮肤麻木的临床研究  

Total knee arthroplasty classic incision and improved the lateral skin incision postoperative incision numbness of clinical research

作　　者：薛金伟[1] 任明远 陈涛平[1] 马铮[1] 梁志兴[1] XUE Jin-wei;REN Ming-yuan;CHEN Tao-ping(Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]河北大学附属医院,河北保定071000 [2]河北大学临床医学院,河北保定071000

出　　处：《中国实验诊断学》2023年第4期399-402,共4页Chinese Journal of Laboratory Diagnosis

基　　金：河北省卫健委青年科技课题(20220638)。

摘　　要：目的通过比较两种不同手术切口对全膝关节表面置换术(TKA)术后外侧皮肤麻木的影响,为减少TKA术后切口外侧皮肤麻木提供参考,同时对麻木产生的原因做出诊断。方法选取2021年1月至2021年9月于河北大学附属医院行初次膝关节置换术患者105名,随机分为A、B两组,采用不同手术切口,测量患者术后2周、1月、3月、6月、1年的皮肤麻木面积及麻木发生率,比较两种手术切口术后膝关节切口外侧皮肤麻木的差异。结果改良手术切口术后皮肤麻木发生率小于经典手术切口,具有统计学意义(P<0.05);改良手术切口术后皮肤麻木面积小于经典手术切口(P<0.001);随时间变化,麻木面积总体呈现递减趋势,部分患者切口外侧麻木可完全恢复。结论改良手术切口较经典手术切口术后切口外侧麻木发生率更小;改良手术切口较经典手术切口对于减少膝关节表面置换术后皮肤麻木发生率及麻木面积有积极的意义;TKA术后切口外侧皮肤麻木可诊断为隐神经髌下支损伤。Objective By comparing the effects of two different surgical incisions on the lateral skin numbness after TKA,this paper provides a reference for reducing the lateral skin numbness after TKA,and makes a diagnosis of the causes of numbness.Methods 105 patients who underwent initial knee arthroplasty in the Affiliated Hospital of Hebei University from January 2021 to September 2021 were randomly divided into two groups:group A and group B.Different surgical incisions were used to measure the area of skin numbness and the incidence of numbness after 2 weeks,l month,3 months,6 months and 1 year of operation.Through statistical analysis,the differences between the two surgical incisions were compared.Result The incidence of skin numbness after modified surgical incision was lower than that of classical surgical incision(P<0.05);The numbness area of skin after modified surgical incisions was smaller than that of classical surgical incisions(P<0.001);With the change of time,the numbness area showed a decreasing trend,and some patients could completely recover from the numbness outside the incision.Conclusion The incidence of numbness on the lateral side of the modified incision is lower than that of the classical incision;Compared with the classical surgical incision,the modified surgical incision has positive significance in reducing the incidence and area of skin numbness after knee joint surface replacement;Skin numbness on the lateral side of the incision after TKA can be diagnosed as infrapatellar branch injury of the saphenous nerve.

关 键 词：全膝关节表面置换 切口 皮肤麻木 

分 类 号：R687.42[医药卫生—骨科学]