全膝关节置换术加速康复:单向倒刺线连续缝合与可吸收线连续锁边缝合应用  

Enhanced Recovery after Total Knee Replacement:Application of Continuous Suturing of One-way Barbed Sutures and Continuous Lock Suturing of Absorbable Sutures

作　　者：张存[1] 袁宇飞 李冠军[1] 刘文波[2] 刘婷婷 颜珍珍 李媛媛 谢洋 苗洁[1] ZHANG Cun;YUAN Yu-fei;LI Guan-jun;LIU Wen-bo;LIU Ting-ting;YAN Zhen-zhen;LI Yuan-yuan;XIE Yang;MIAO Jie(The Fifth Department of Orthopedics,Handan Central Hospital,Handan 056001,China;The Department of Orthopedics,980th Hospital of Chinese People s Liberation Army Joint Logistic Support Force(Handan Hospital),Handan 056005,China;The Sixth Department of Orthopedics,Handan Central Hospital,Handan 056001,China;Department of Operating Room,Handan Central Hospital,Handan 056001,China)

机构地区：[1]邯郸市中心医院骨五科,邯郸056001 [2]中国人民解放军联勤保障部队第980医院邯郸院区骨科,邯郸056005 [3]邯郸市中心医院骨六科,邯郸056001 [4]邯郸市中心医院手术室,邯郸056001

出　　处：《科学技术与工程》2023年第32期13741-13746,共6页Science Technology and Engineering

基　　金：河北省卫生健康委医学课题基金(20220558)。

摘　　要：为探讨单向倒刺线连续缝合与可吸收线连续锁边缝合在全膝关节置换术加速康复中的临床应用效果,回顾性分析2020年3月—2022年6月邯郸市中心医院行初次全膝关节置换手术的106例患者,分为对照组(52例)和观察组(54例)。对照组采用可吸收线连续锁边缝合切口,观察组采用单向倒刺线连续缝合切口。比较两组缝合时间、手术时间、失血量和术后住院时间、膝关节活动度(range of motion,ROM)、膝关节功能以及并发症差异。结果表明:观察组缝合时间短于对照组(P<0.05),皮下瘀斑、针刺伤发生率低于对照组(P<0.05)。观察组手术时间、平均失血量和平均住院时间、术后7 d美国纽约特种外科医院评分(hospital for special surgery knee score,HSS)、Rasmussen评分、膝关节ROM、切口红肿、切口感染、切口延迟愈合发生率与对照组比较差异无统计学意义(P>0.05)。可见单向倒刺线连续缝合可缩短缝合时间,降低术后皮下瘀斑和针刺伤发生率,有利于患者术后功能的恢复,缩短住院时间,在全膝关节置换术加速康复中具有一定优势。In order to investigate the clinical effect of unidirectional barbed continuous suture and continuous edge stitching with absorbable thread in accelerated rehabilitation of total knee arthroplasty.A total of 106 patients who underwent total knee replacement surgery in Handan Central Hospital from March 2020 to June 2022 were selected and divided into control group(52 cases)and observation group(54 cases).In the control group,the incision was continuously hemmed and sutured with absorbable wire,and in the observation group,the incision was continuously sutured with one-way barbed wire.The differences in suture time,operation time,blood loss,postoperative hospital stay,knee function,knee range of motion(ROM)and complications were compared between the two groups.The results show that the suture time of observation group is shorter than that of control group(P<0.05),and the incidence of subcutaneous ecchymosis and needle puncture is lower than that of control group(P<0.05).There are no significant differences in operation time,mean blood loss,mean length of hospital stay,hospital for special surgery knee score(HSS),Rasmussen score,knee ROM,incidence of incision redness,incision infection and delayed incision healing between the two groups(P>0.05).It is concluded that Unidirectional barbed continuous suture can shorten the suture time,reduce the incidence of postoperative subcutaneous ecchymosis and needle puncture,and has certain advantages in accelerating the rehabilitation of total knee replacement incision suture.

关 键 词：单向倒刺线连续缝合 可吸收线连续锁边缝合 全膝关节置换术 加速康复外科 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687