内侧单髁膝关节置换与全膝关节置换术后血液成分变化的临床对比观察  

Clinical comparison of blood composition changes after two different methods

作　　者：陈宾[1] 邹士平[1] 王跃辉[1] 周宇[1] 陈明伟 陈文忠 司文腾[1] Chen Bin;Zou Shiping;Wang Yuehui;Zhou Yu;Chen Mingwei;Chen Wenzhong;Si Wenteng(Department of Joint Disease,Zheng Zhou Orthopaedics Hospital,Zhengzhou 450052,China)

机构地区：[1]郑州市骨科医院关节病科,450052

出　　处：《骨科临床与研究杂志》2023年第6期341-344,368,共5页Journal Of Clinical Orthopedics And Research

摘　　要：目的通过比较内侧间室膝关节骨关节炎患者在内侧单髁膝关节置换(UKA)或全膝关节置换(TKA)术后血液成分的变化,判断两种手术方式对机体血液学的影响。方法对2020年1月至2022年12月郑州市骨科医院关节病科因内侧间室膝关节骨关节炎接受关节置换术治疗的72例患者相关临床结果进行统计分析。患者分为UKA组和TKA组。UKA组33例,其中男10例,女23例;年龄52~76[63(58,68)]岁;BMI 20.8~34.9[25.3(23.2,29.1)]kg/m^(2)。TKA组39例,其中男11例,女28例;年龄51~78[64(58,68)]岁;BMI 19.5~35.0[26.0(22.9,30.4)]kg/m^(2)。比较围手术期两组患者术后引流量,以及并发症发生率。比较两组术前和术后第1、4、7天血液白细胞(WBC)计数、中性粒细胞(NEU)计数、中性粒细胞百分比(NEU%)、超敏C-反应蛋白(hs-CRP)等各指标的变化结果。结果UKA组患者术后平均引流量120(80,130)ml,TKA组患者术后平均引流量190(150,340)ml,差异有统计学意义(P<0.05)。术前术后各时间点超敏C-反应蛋白的比较,术后第1、4天两组患者的超敏C-反应蛋白差异有统计学意义(P<0.05)。两组患者术后第7天白细胞、中性粒细胞计数与中性粒细胞百分比差异有统计学意义(P<0.05)。两组患者超敏C-反应蛋白、白细胞、中性粒细胞和中性粒细胞百分比的差异发生在术后不同的时间点。两组患者无感染及切口愈合不良发生,患者均顺利康复出院。结论与TKA手术相比UKA在术后对血液学的不良影响小。Objective To compare the changes of blood components of medial ventricular knee osteoarthritis after medial unicompartmental knee arthroplasty(UKA)and total knee arthroplasty(TKA),and to determine the influence of the two surgical methods on the internal environment of hematology.Methods From January 2020 to December 2022,the clinical results of 72 patients who underwent joint replacement in single compartment KOA in Department of Joint Disease,Zheng Zhou Orthopaedics Hospital were collected.The subjects were divided into UKA group and TKA group.There were 33 cases in the UKA group,including 10 males and 23 females;age 52-76[63(58,68)]years;BMI 20.8-34.9[25.3(23.2,29.1)]kg/m^(2).39 cases in the TKA group,including 11 males and 28 females;age 51-78[64(58,68)]years;BMI 19.5-35.0[26.0(22.9,30.4)]kg/m^(2).Postoperative drainage volume and complication rate were compared.The venous blood white blood cell count,neutrophil count,neutrophil percentage and CRP were compared before and 1,4 and 7 days after operation.Results The average postoperative drainage volume of patients in the UKA group was[120(80,130)]ml,and the TKA group was[190(150,340)]ml.The statistical analysis showed that the difference was statistically significant(P<0.05).The overall mean of CRP was different between the two groups on the 1st and 4th day after surgery(P<0.05).The overall mean of WBC and NEU and NEU%level were different between the two groups on the 7th day after surgery(P<0.05).Difference between two groups of patients in white blood cells and hypersensitivity of C-reactive protein occurred in the different time points.No infection and poor wound healing occurred in the two groups,and all patients recovered completely and were discharged smoothly.Conclusions Compared with TKA,UKA has less adverse effects on blood components after surgery.

关 键 词：骨关节炎 膝 关节成形术 置换 膝 血液化学分析 

分 类 号：R687.4[医药卫生—骨科学]