临床和实验医学杂志
臨床和實驗醫學雜誌
림상화실험의학잡지
JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
2015年
11期
898-901
,共4页
徐飞%宋莺春%李霞%邢恩鸿%杨阳%杜元良%张立超%戴海峰%董晓强%何文静%张艳波%吕永明
徐飛%宋鶯春%李霞%邢恩鴻%楊暘%杜元良%張立超%戴海峰%董曉彊%何文靜%張豔波%呂永明
서비%송앵춘%리하%형은홍%양양%두원량%장립초%대해봉%동효강%하문정%장염파%려영명
膝关节置换术%体温升高%相关性%氨甲环酸%“鸡尾酒”镇痛%止血带
膝關節置換術%體溫升高%相關性%氨甲環痠%“鷄尾酒”鎮痛%止血帶
슬관절치환술%체온승고%상관성%안갑배산%“계미주”진통%지혈대
Knee arthroplasty%Elevated body temperature%Relevance%Tranexamic acid%"Cocktail" analgesic%Tourniquet
目的：探讨膝关节置换术后体温升高与手术操作的相关性。方法选择在2008年3月到2014年3月收治的骨关节炎患者72例，均给予膝关节置换术。观察术后体温升高与预后情况，同时对患者的基础资料、疾病资料、手术资料与术后资料进行详细调查与相关性分析。结果所有患者都顺利完成手术，术后体温升高9例，发生率为18.8%。术后患者血红蛋白值明显低于术前，而ESR与CRP值明显高于术前，差异有统计学意义（ P <0.05）。多元Logistic回归分析结果显示止血带应用“、鸡尾酒”镇痛、氨甲环酸应用、夹闭引流管、棉垫加压包扎是影响术后体温升高的独立危险因素（P<0.05）。Person相关分析结果显示氨甲环酸应用“、鸡尾酒”镇痛与止血带应用与术后体温升高的发生有明显负向相关性（ P <0.05）。术后3个月进行评定，患者的Hss评分为92.87±6.22分，明显高于术前的44.72±5.01分（ P <0.05）。结论膝关节置换术后体温升高在临床上比较常见，多伴随有ESR、血红蛋白与CRP的异常，氨甲环酸应用、“鸡尾酒”镇痛与止血带应用与术后体温升高的发生有明显相关性，要积极进行手术改进操作。
目的：探討膝關節置換術後體溫升高與手術操作的相關性。方法選擇在2008年3月到2014年3月收治的骨關節炎患者72例，均給予膝關節置換術。觀察術後體溫升高與預後情況，同時對患者的基礎資料、疾病資料、手術資料與術後資料進行詳細調查與相關性分析。結果所有患者都順利完成手術，術後體溫升高9例，髮生率為18.8%。術後患者血紅蛋白值明顯低于術前，而ESR與CRP值明顯高于術前，差異有統計學意義（ P <0.05）。多元Logistic迴歸分析結果顯示止血帶應用“、鷄尾酒”鎮痛、氨甲環痠應用、夾閉引流管、棉墊加壓包扎是影響術後體溫升高的獨立危險因素（P<0.05）。Person相關分析結果顯示氨甲環痠應用“、鷄尾酒”鎮痛與止血帶應用與術後體溫升高的髮生有明顯負嚮相關性（ P <0.05）。術後3箇月進行評定，患者的Hss評分為92.87±6.22分，明顯高于術前的44.72±5.01分（ P <0.05）。結論膝關節置換術後體溫升高在臨床上比較常見，多伴隨有ESR、血紅蛋白與CRP的異常，氨甲環痠應用、“鷄尾酒”鎮痛與止血帶應用與術後體溫升高的髮生有明顯相關性，要積極進行手術改進操作。
목적：탐토슬관절치환술후체온승고여수술조작적상관성。방법선택재2008년3월도2014년3월수치적골관절염환자72례，균급여슬관절치환술。관찰술후체온승고여예후정황，동시대환자적기출자료、질병자료、수술자료여술후자료진행상세조사여상관성분석。결과소유환자도순리완성수술，술후체온승고9례，발생솔위18.8%。술후환자혈홍단백치명현저우술전，이ESR여CRP치명현고우술전，차이유통계학의의（ P <0.05）。다원Logistic회귀분석결과현시지혈대응용“、계미주”진통、안갑배산응용、협폐인류관、면점가압포찰시영향술후체온승고적독립위험인소（P<0.05）。Person상관분석결과현시안갑배산응용“、계미주”진통여지혈대응용여술후체온승고적발생유명현부향상관성（ P <0.05）。술후3개월진행평정，환자적Hss평분위92.87±6.22분，명현고우술전적44.72±5.01분（ P <0.05）。결론슬관절치환술후체온승고재림상상비교상견，다반수유ESR、혈홍단백여CRP적이상，안갑배산응용、“계미주”진통여지혈대응용여술후체온승고적발생유명현상관성，요적겁진행수술개진조작。
Objective To investigate the correlation between the postoperative elevated body temperature and surgical operations for the knee replacement surgery patients. Methods 72 osteoarthritis patients from March 2008 to March 2014 in our hospital were selected into this study. All patients were given the active knee replacement surgery. The postoperative body temperature situation and prognosis were observed, while the patientsˊinformation disease data,surgical data and postoperative data were given detailed survey and correlation analyzed. Results All patients were successfully completed surgery,there were 9 patients were postoperative elevated body temperature,the rate was 18. 8%. And the postoperative hemoglobin value was significantly lower than the preoperative,while the postoperative ESR and CRP values were significantly higher than the preoperative( P <0. 05). Multivariate logistic regression analysis showed that tourniquet application,"cocktail" analgesic,tranexamic acid application,clipping drainage tube,pad pressure bandage were the independent risk factor for postoperative body temperature( P <0. 05). Person correlation analysis showed that tranexamic acid applications,"cocktail" of postoperative analgesia and tourniquet application were negative to the occurrence of postoperative elevated body temperature( P <0. 05). Evaluated after three months,the patientˊs Hss score was 92. 87 ± 6. 22 points that were significantly higher than the preoperative 44.72 ±5.01 scores(P <0.05). Conclusion The postoperative elevated body tem-perature in the knee replacement is relatively common in clinical practice,and is more accompanied by hemoglobin ,ESR,CRP abnormal,tranex-amic acid applications,"cocktail" analgesic and tourniquet application are more related to the postoperative elevated body temperature,we should actively improve surgical operation.
