CAJ | 학술논문

目的：比较全膝关节置换术（total knee arthroplasty，TKA）中不处理股骨隧道口、骨水泥填塞及自体骨块填塞三种不同处理方式的效果差异。方法90例行 TKA 患者按随机数字表法分为三组，A 组采用自体骨块填塞，B 组采用骨水泥填塞，C 组不处理股骨隧道口，对三组患者术后相关数据进行统计分析。结果A、B 组与 C 组术中出血量差异无统计学意义（P＞0．05）；A、B 组术后围手术期总失血量、24 h 引流量和输血量均少于 C 组（P ＜0．05），术后各时间点血红蛋白（HGB）及红细胞压积（HCT）水平均高于 C 组（P ＜0．05）。三组输血率分别为10％、13．3％和33．3％，差异有统计学意义（P ＜0．05）。 A、B组之间各项数据差异均无统计学意义（P ＞0．05）。结论TKA 中自体骨块填塞股骨隧道技术可显著减少出血量，其效果与骨水泥填塞技术相当，同时作为自体移植物安全可靠，避免了骨水泥填塞所带来的如骨水泥颗粒脱落、栓塞等风险，效果明显。
목적：비교전슬관절치환술（total knee arthroplasty，TKA）중불처리고골수도구、골수니전새급자체골괴전새삼충불동처리방식적효과차이。방법90례행 TKA 환자안수궤수자표법분위삼조，A 조채용자체골괴전새，B 조채용골수니전새，C 조불처리고골수도구，대삼조환자술후상관수거진행통계분석。결과A、B 조여 C 조술중출혈량차이무통계학의의（P＞0．05）；A、B 조술후위수술기총실혈량、24 h 인류량화수혈량균소우 C 조（P ＜0．05），술후각시간점혈홍단백（HGB）급홍세포압적（HCT）수평균고우 C 조（P ＜0．05）。삼조수혈솔분별위10％、13．3％화33．3％，차이유통계학의의（P ＜0．05）。 A、B조지간각항수거차이균무통계학의의（P ＞0．05）。결론TKA 중자체골괴전새고골수도기술가현저감소출혈량，기효과여골수니전새기술상당，동시작위자체이식물안전가고，피면료골수니전새소대래적여골수니과립탈락、전새등풍험，효과명현。
Objective To compare the effects of three different treatments :no treatment on femoral tunnel or filling with autol -ogous bone or cements plug during total knee arthroplasty (TKA).Methods Ninety patients undergone TAK were randomly divided in -to A,B and C groups.The group A was treated with autologous bone plugs .The group B was treated with cements.The group C was left the femoral intramedullary defect open .The relative data after operation were statistically analyzed .Results There was no significant difference in intraoperative blood loss among the three groups (P >0.05).The amount of total blood loss and the amount postoperative wound drainage in 24 h after operation in the group A and B were less than that in the group C (P <0.05).The blood transfusion rates in the group A,B and C were 10%,13.3% and 33.3%,respectively.The levels of HGB and HCT in the group A and B were higher than that in the group C(P <0.05).The differences were statistically significant (P <0.05).However,there was no significant differ-ence in all parameters between the group A and B (P >0.05).Conclusion The autologous bone filling femoral tunnel in TKA can significantly reduce the amount of perioperative blood loss and blood transfusion needs .Its effect is similar to cements but safer as auto-graft avoiding the risks such as bone cement particles fall off and embolization .