中华骨科杂志
中華骨科雜誌
중화골과잡지
CHINESE JOURNAL OF ORTHOPAEDICS
2012年
5期
437-441
,共5页
关节成形术,置换,膝%感觉减退%随访研究
關節成形術,置換,膝%感覺減退%隨訪研究
관절성형술,치환,슬%감각감퇴%수방연구
Arthroplasty,replacement,knee%Hypesthesia%Follow-up studies
目的 随访分析全膝关节置换术(total knee arthroplasty,TKA)后切口外侧皮肤感觉障碍的转归、相关因素及其对关节功能的影响.方法 连续选取36例(53膝)施行TKA的患者,术后1周测量切口长度和切口周围皮肤感觉障碍区域的面积.术后1.5年对患者进行随访,复测切口周围感觉障碍区域面积,记录膝关节活动度、膝关节协会临床评分和功能评分(knee society score,KSS).结果 所有患者在TKA术后均出现切口外侧皮肤客观感觉减退,26例(26/36,72％)患者存在主观麻木感,有主观麻木感觉的患者痛觉和触觉减退面积均大于无主观麻木感觉者.术后1周,触觉减退面积为(36.43±14.71) cm2,痛觉减退面积为(69.62±23.48) cm2,二者均与切口长度呈正相关(r值分别为0.303和0.318,P值分别为0.04和0.03).术后1.5年,所有患者无触觉减退区,痛觉减退面积为(8.55±4.56) cm2,与术后1周时比较,差异有统计学意义(t=2.553,P=0.012),其中有5例患者感觉减退完全恢复；有主观麻木患者KSS临床评分低于无主观麻木感觉者(t=2.066,P=0.044).结论 TKA术后普遍存在切口外侧皮肤感觉减退,可随时间部分或完全恢复.TKA术前应明确告知患者切口外侧皮肤感觉障碍及其转归,以减少对其心理和功能康复的负面影响.
目的 隨訪分析全膝關節置換術(total knee arthroplasty,TKA)後切口外側皮膚感覺障礙的轉歸、相關因素及其對關節功能的影響.方法 連續選取36例(53膝)施行TKA的患者,術後1週測量切口長度和切口週圍皮膚感覺障礙區域的麵積.術後1.5年對患者進行隨訪,複測切口週圍感覺障礙區域麵積,記錄膝關節活動度、膝關節協會臨床評分和功能評分(knee society score,KSS).結果 所有患者在TKA術後均齣現切口外側皮膚客觀感覺減退,26例(26/36,72％)患者存在主觀痳木感,有主觀痳木感覺的患者痛覺和觸覺減退麵積均大于無主觀痳木感覺者.術後1週,觸覺減退麵積為(36.43±14.71) cm2,痛覺減退麵積為(69.62±23.48) cm2,二者均與切口長度呈正相關(r值分彆為0.303和0.318,P值分彆為0.04和0.03).術後1.5年,所有患者無觸覺減退區,痛覺減退麵積為(8.55±4.56) cm2,與術後1週時比較,差異有統計學意義(t=2.553,P=0.012),其中有5例患者感覺減退完全恢複；有主觀痳木患者KSS臨床評分低于無主觀痳木感覺者(t=2.066,P=0.044).結論 TKA術後普遍存在切口外側皮膚感覺減退,可隨時間部分或完全恢複.TKA術前應明確告知患者切口外側皮膚感覺障礙及其轉歸,以減少對其心理和功能康複的負麵影響.
목적 수방분석전슬관절치환술(total knee arthroplasty,TKA)후절구외측피부감각장애적전귀、상관인소급기대관절공능적영향.방법 련속선취36례(53슬)시행TKA적환자,술후1주측량절구장도화절구주위피부감각장애구역적면적.술후1.5년대환자진행수방,복측절구주위감각장애구역면적,기록슬관절활동도、슬관절협회림상평분화공능평분(knee society score,KSS).결과 소유환자재TKA술후균출현절구외측피부객관감각감퇴,26례(26/36,72％)환자존재주관마목감,유주관마목감각적환자통각화촉각감퇴면적균대우무주관마목감각자.술후1주,촉각감퇴면적위(36.43±14.71) cm2,통각감퇴면적위(69.62±23.48) cm2,이자균여절구장도정정상관(r치분별위0.303화0.318,P치분별위0.04화0.03).술후1.5년,소유환자무촉각감퇴구,통각감퇴면적위(8.55±4.56) cm2,여술후1주시비교,차이유통계학의의(t=2.553,P=0.012),기중유5례환자감각감퇴완전회복；유주관마목환자KSS림상평분저우무주관마목감각자(t=2.066,P=0.044).결론 TKA술후보편존재절구외측피부감각감퇴,가수시간부분혹완전회복.TKA술전응명학고지환자절구외측피부감각장애급기전귀,이감소대기심리화공능강복적부면영향.
Objective To investigate the sequelae and relative factors of sensation disorders of lateral skin of the incision after total knee arthroplasty (TKA) and to explore its effect on knee function.Methods Thirty-six patients (53 knees) who underwent TKA were continuously selected in this study.The length of the incision and the area of sensation disorders of skin around the incision were measured 1 week postoperatively.The area of sensation disorders of skin around the incision was measured again 1.5 years postoperatively,and the range of motion of the knee and the knee society score (KSS) were recorded.Results All of the patients presented with objective hypesthesia of lateral skin of the incision.Twenty-six (72％) patients existed subjective numbness,whose areas of hypesthesia were larger than those of patients without subjective numbness.The average area of hypopselaphesia and average area of hypalgesia were (36.43±14.71) cm2 and (69.62±23.48) cm2,respectively.Both of them had positive correlation with the length of the incision (r=0.303,P=0.04; r=0.318,P=0.03).One and a half years postoperatively,besides 5 patients recovered completely,all other patients existed no hypopselaphesia,and the average area of hypalgesia was (8.55±4.56)cm2,which was statistically different with that 1 week postoperatively(t=2.553,P=0.012).The KSS score was lower in patients with subjective numbness than that in patients without subjective numbness (t=2.066,P=0.044).Conclusion The hypesthesia of lateral skin of the incision is common after TKA,which can recover partially or completely over time.All patients should be advised of this complication as part of their informed consent before TKA.
