缝合时屈曲角度摆放对全膝关节置换术患者术后切口愈合、疼痛程度及膝关节功能恢复的影响  

The effect of flexion angle placement on wound healing,pain degree and functional recovery of knee joint in patients with total knee arthroplasty

作　　者：都银丽 尚倩倩 仝桃珠 Du Yinli;Shang Qianqian;Tong Taozhu(Operation Room,Xuchang Hospital of Traditional Chinese Medicine,Xuchang 461000,China)

机构地区：[1]许昌中医院手术室,461000

出　　处：《国际移植与血液净化杂志》2023年第5期26-30,共5页International Journal of Transplantation and Hemopurification

摘　　要：目的探究缝合时屈曲角度摆放对全膝关节置换术(total knee arthroplasty,TKA)患者术后切口愈合、疼痛程度及膝关节功能恢复的影响。方法选取许昌中医院手术室2020年10月至2022年10月期间收治的117例TKA患者作为研究对象,采用数字表法随机分为伸直位组和屈曲位组。伸直位组58例患者给予伸直位连续缝合关闭切口,屈曲位组59例患者给予膝关节屈曲90°连续缝合切口,对比两组患者手术指标、疼痛程度、膝关节功能和术后并发症。结果两组患者切口长度比较,差异无统计学意义(P>0.05)。屈曲位组患者缝合时间长于伸直位组,术后失血量、曲马多用量少于伸直位组(P<0.05)。两组患者术后1~5 d视觉模拟评分量表(visual analog scale,VAS)分值呈逐渐降低趋势,屈曲位组患者术后1、3、5 d VAS评分低于伸直位组(P<0.05)。两组患者术后1个月膝关节协会评分系统(knee society score,KSS)分值及膝关节主动活动度(active range of motion,AROM)、被动活动度(passive range of motion,PROM)较术前升高,且屈曲位组高于伸直位组(P<0.05)。经Fisher确切概率法检验,屈曲位组患者并发症发生率[1.69%(1/59)]与伸直位组[5.17%(3/58)]比较差异无统计学意义(P>0.05)。结论缝合时屈曲角度摆放可改善TKA患者手术指标,减轻疼痛程度,促进膝关节功能恢复,安全性良好。Objective To explore the effects of flexion angle placement on wound healing,pain degree and functional recovery of knee joint in patients with total knee arthroplasty(TKA).Methods A total of 117 TKA patients in Operation Room,Xuchang Hospital of Traditional Chinese Medicine from October 2020 to October 2022 were selected as the study subjects,and were divided into the extension group and the flexion group by random number table method.Fifty-eight patients in the extension group were given continuous suture to close the incision,and 59 patients in the flexion group were given continuous suture to close the incision with 90°knee flexion.The surgical indexes,pain degree,knee function and postoperative complications were compared between the two groups.Results There was no difference in incision length between the two groups(P>0.05).The suture time in flexion group was higher than that in extension group,and the levels of blood loss and tramadol dosage after operation were lower than those in extension group(P<0.05).The visual analog scale(VAS)scores of the two groups showed a gradually decreasing trend from 1 to 5 days after surgery,and the VAS scores of the flexion group at 1,3 and 5 days after surgery were lower than those of the extension group(P<0.05).The knee society score(KSS),active knee motion(AROM)and passive knee motion(PROM)levels were higher in both groups one month after surgery,and those in flexion group were higher than those in extension group(P<0.05).By Fisher’s exact probability test,there was no difference in complication rate between the flexor group(1.69%(1/59))and the extension group(5.17%(3/58))(P>0.05).Conclusion Flexion angle placement during suturing can improve surgical indexes,alleviate pain and promote functional recovery of knee joint in TKA patients with good safety.

关 键 词：屈曲角度摆放 全膝关节置换术 疼痛程度 膝关节功能 

分 类 号：R687.4[医药卫生—骨科学]