中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
22期
3457-3461
,共5页
徐飞%吕永明%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
徐飛%呂永明%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
서비%려영명%송앵춘%리하%형은홍%양양%두원량%장립초%대해봉%동효강%하문정%장염파
人工假体%人工全膝关节置换%血红蛋白%危险因素%冰敷干预%高危因素%优良率%骨性关节炎%疼痛%年龄%体质量指数
人工假體%人工全膝關節置換%血紅蛋白%危險因素%冰敷榦預%高危因素%優良率%骨性關節炎%疼痛%年齡%體質量指數
인공가체%인공전슬관절치환%혈홍단백%위험인소%빙부간예%고위인소%우량솔%골성관절염%동통%년령%체질량지수
背景：减少人工全膝关节置换后出血量与血红蛋白降低量成为骨关节科临床研究的重要课题。当前冰敷疗法已被广泛应用于临床上由于各种理化原因导致的局部组织肿胀的消肿、止痛等的常规治疗中。目的：调查人工全膝关节置换后血红蛋白降低的危险因素，探讨冰敷干预应用的效果。方法：骨性关节炎患者240例根据随机抽签原则分为治疗组与对照组各120例，对两组的基本信息、疾病状况、诊治情况与预后情况都进行了调查。对照组积极给予人工全膝关节置换；在此基础上治疗组在置换后2 h开始冰敷治疗，连续7 d。结果与结论：置换后7 d，240例患者置换后发生血红蛋白降低者为34例，发生率为14.2%。多元回归Logistic分析结果显示，患者年龄、未冰敷处理、体质量指数是导致人工全膝关节置换后血红蛋白降低的危险因素(P <0.05)。与对照组相比，治疗组置换后的血红蛋白值明显升高(P <0.05)，血红蛋白降低值、总失血量、输血率、输血量、置换后第3，7天的疼痛评分均显著降低(P <0.05)。治疗组的膝关节功能优良率为96.7%，对照组为95.8%，两组差异无显著性意义(P >0.05)。结果证实，人工全膝关节置换在临床上的应用能促进骨性关节炎患者的膝关节恢复，但是存在血红蛋白大幅度下降与出血的危险，积极地置换后冰敷干预降低危险，并且缓解置换后疼痛。
揹景：減少人工全膝關節置換後齣血量與血紅蛋白降低量成為骨關節科臨床研究的重要課題。噹前冰敷療法已被廣汎應用于臨床上由于各種理化原因導緻的跼部組織腫脹的消腫、止痛等的常規治療中。目的：調查人工全膝關節置換後血紅蛋白降低的危險因素，探討冰敷榦預應用的效果。方法：骨性關節炎患者240例根據隨機抽籤原則分為治療組與對照組各120例，對兩組的基本信息、疾病狀況、診治情況與預後情況都進行瞭調查。對照組積極給予人工全膝關節置換；在此基礎上治療組在置換後2 h開始冰敷治療，連續7 d。結果與結論：置換後7 d，240例患者置換後髮生血紅蛋白降低者為34例，髮生率為14.2%。多元迴歸Logistic分析結果顯示，患者年齡、未冰敷處理、體質量指數是導緻人工全膝關節置換後血紅蛋白降低的危險因素(P <0.05)。與對照組相比，治療組置換後的血紅蛋白值明顯升高(P <0.05)，血紅蛋白降低值、總失血量、輸血率、輸血量、置換後第3，7天的疼痛評分均顯著降低(P <0.05)。治療組的膝關節功能優良率為96.7%，對照組為95.8%，兩組差異無顯著性意義(P >0.05)。結果證實，人工全膝關節置換在臨床上的應用能促進骨性關節炎患者的膝關節恢複，但是存在血紅蛋白大幅度下降與齣血的危險，積極地置換後冰敷榦預降低危險，併且緩解置換後疼痛。
배경：감소인공전슬관절치환후출혈량여혈홍단백강저량성위골관절과림상연구적중요과제。당전빙부요법이피엄범응용우림상상유우각충이화원인도치적국부조직종창적소종、지통등적상규치료중。목적：조사인공전슬관절치환후혈홍단백강저적위험인소，탐토빙부간예응용적효과。방법：골성관절염환자240례근거수궤추첨원칙분위치료조여대조조각120례，대량조적기본신식、질병상황、진치정황여예후정황도진행료조사。대조조적겁급여인공전슬관절치환；재차기출상치료조재치환후2 h개시빙부치료，련속7 d。결과여결론：치환후7 d，240례환자치환후발생혈홍단백강저자위34례，발생솔위14.2%。다원회귀Logistic분석결과현시，환자년령、미빙부처리、체질량지수시도치인공전슬관절치환후혈홍단백강저적위험인소(P <0.05)。여대조조상비，치료조치환후적혈홍단백치명현승고(P <0.05)，혈홍단백강저치、총실혈량、수혈솔、수혈량、치환후제3，7천적동통평분균현저강저(P <0.05)。치료조적슬관절공능우량솔위96.7%，대조조위95.8%，량조차이무현저성의의(P >0.05)。결과증실，인공전슬관절치환재림상상적응용능촉진골성관절염환자적슬관절회복，단시존재혈홍단백대폭도하강여출혈적위험，적겁지치환후빙부간예강저위험，병차완해치환후동통。
BACKGROUND:To reduce the amount of bleeding and the amount of hemoglobin after total knee replacement has been a key project in the clinical research in the division of bone and joint. Currently, ice therapy has been widely used in the clinic for tissue sweling and pain due to various physical and chemical factors. OBJECTIVE:To investigate the risk factors of postoperative hemoglobin after total knee replacement and discuss the effects of ice intervention. METHODS: 240 patients with osteoarthritis based on the random draw principles were equaly divided into the treatment group and the control group. The general information, disease status, diagnosis and treatment and prognosis of the two groups were investigated. Al patients were actively subjected to artificial total knee replacement. On the basis of the treatment in the control group, the treatment group received ice intervention at 2 hours after replacement for 7 consecutive days. RESULTS AND CONCLUSION:The postoperative hemoglobin decrease occurred in 34 patients, with the incidence of 14.2% among 240 patients at 7 days after replacement. Multivariate logistic regression analysis results showed that age, no ice treatment, body mass index were the main risk factors for hemoglobin decrease after total knee replacement (P < 0.05). Compared with the control group, the postoperative hemoglobin values of the treatment group were significantly higher (P < 0.05). Hemoglobin decrease values, total blood loss, blood transfusion rate, blood transfusion amount, and pain score at 3 and 7 days after replacement were significantly lower in the treatment group than in the control group (P < 0.05). The knee function excelent and good rate was 96.7% in the treatment group, and 95.8% in the control group, which showed no significant difference (P > 0.05). Results verify that clinical application of total knee replacement facilitated the knee recovery in patients with osteoarthritis, but hemoglobin decrease and bleeding existed. Active ice intervention can reduce the risk and relieve postoperative pain.
