CAJ | 학술논문

目的：探讨围术期感染在膝关节镜下自体移植重建前交叉韧带中的重要性，以提高临床诊治水平。方法选取2005年2月－2013年2月1050例前交叉韧带断裂手术患者为研究对象，随机分组，对照组520例，予常规的关节镜下自体移植重建前交叉韧带术，观察组530例，在对照组基础上加强围术期感染预防的管理，观察治疗后在感染相关指标和临床效果。结果对照组感染率2．50％，观察组感染率0．94％，两组比较差异有统计学意义（P＜0．05）；对照组白细胞计数（15．54±2．34）×109／L、C‐反应蛋白（63．44±21．58）mg／L、IL‐1（75．68±34．31） ng／ml ，观察组分别为（11．37±1．95）×109／L、（34．57±16．46）mg／L、（34．24±13．58）ng／ml ，两组比较差异有统计学意义（P＜0．05）；对照组住院时间（12．4±3．4）d、生活质量评分（78．5±12．5）分、视觉模拟评分（6．8±2．1）分、下床活动时间（9．7±2．1）周、渗液消失时间（6．7±1．5）d，观察组分别为（10．6±2．9）d、（89．4±14．6）分、（9．5±3．1）分、（8．4±1．9）周、（5．8±1．1）d，两组比较差异有统计学意义（P＜0．05）。结论围术期注重预防感染有助于提高膝关节镜下自体移植重建前交叉韧带术后的临床效果，降低并发症的发生率。
목적：탐토위술기감염재슬관절경하자체이식중건전교차인대중적중요성，이제고림상진치수평。방법선취2005년2월－2013년2월1050례전교차인대단렬수술환자위연구대상，수궤분조，대조조520례，여상규적관절경하자체이식중건전교차인대술，관찰조530례，재대조조기출상가강위술기감염예방적관리，관찰치료후재감염상관지표화림상효과。결과대조조감염솔2．50％，관찰조감염솔0．94％，량조비교차이유통계학의의（P＜0．05）；대조조백세포계수（15．54±2．34）×109／L、C‐반응단백（63．44±21．58）mg／L、IL‐1（75．68±34．31） ng／ml ，관찰조분별위（11．37±1．95）×109／L、（34．57±16．46）mg／L、（34．24±13．58）ng／ml ，량조비교차이유통계학의의（P＜0．05）；대조조주원시간（12．4±3．4）d、생활질량평분（78．5±12．5）분、시각모의평분（6．8±2．1）분、하상활동시간（9．7±2．1）주、삼액소실시간（6．7±1．5）d，관찰조분별위（10．6±2．9）d、（89．4±14．6）분、（9．5±3．1）분、（8．4±1．9）주、（5．8±1．1）d，량조비교차이유통계학의의（P＜0．05）。결론위술기주중예방감염유조우제고슬관절경하자체이식중건전교차인대술후적림상효과，강저병발증적발생솔。
OBJECTIVE To study the importance of prevention of the perioperative infections in the anterior cruciate ligament rupture patients undergoing arthroscopic autograft reconstruction so as to improve the clinical diagnosis and treatment .METHODS A total of 1 050 patients with anterior cruciate ligament rupture who were treated from Feb 2005 to Feb 2013 were recruited as the study objects and randomly divided into the control group with 520 ca‐ses and the observation group with 530 cases ;the control group was given the conventional arthroscopic autograft reconstruction for anterior cruciate ligament rupture ,while the observation group was paid high attention to the prevention of perioperative infections based on the treatment of the control group .The related indicators for the infections and the clinical effects were observed after the treatment .RESULTS The infection rate was 2 .50% in the control group ,0 .94% in the observation group ,and there was significant difference between the two groups (P<0 .05) .The white blood cells counts were (15 .54 ± 2 .34)× 109/L in the control group ,(11 .37 ± 1 .95)× 109/L in the observation group;the level of C‐reactive protein was (63 .44 ± 21 .58)mg/L in the control group ,(34 .57 ± 16 .46)mg/L in the observation group;the level of IL‐1 was (75 .68 ± 34 .31)ng/ml in the control group ,(34 .24 ± 13 .58)ng/ml in the observation group ,and there was significant difference between the two groups (P<0 .05) . The length of hospital stay was (12 .4 ± 3 .4) days in the control group ,(10 .6 ± 2 .9)days in the observation group;the score of life quality was (78 .5 ± 12 .5)points in the control group ,(89 .4 ± 14 .6) points in the observa‐tion group;the visual analogue scale was (6 .8 ± 2 .1) points in the control group ,(9 .5 ± 3 .1) points in the obser‐vation group;the off‐bed ambulation time was (9 .7 ± 2 .1) weeks in the control group ,(8 .4 ± 1 .9) weeks in the observation group ;the time of disappearance of exudates was (6 .7 ± 1 .5) days in the control group ,(5 .8 ± 1 .1) days in the observation group , and there was significant difference between the two groups ( P < 0 .05 ) . CONCLUSION The prevention of the perioperative infections may contribute to the improvement of clinical effect of arthroscopic autograft reconstruction for anterior cruciate ligament rupture ,as well as the reduction of incidence of complications .