| 计算机导航下全膝关节置换术对术中出血量及关节功能恢复的影响 |
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投稿时间：2019-08-15
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| 作者 | Author | 单位 | Address | E-Mail |
| 于清波 |
YU Qing-bo |
开封市中心医院, 河南 开封 475000 |
Kaifeng Central Hospital, Kaifeng 475000, Henan, China |
710115856@qq.com |
| 鄂正康 |
E Zheng-kang |
开封市中心医院, 河南 开封 475000 |
Kaifeng Central Hospital, Kaifeng 475000, Henan, China |
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| 辛红伟 |
XIN Hong-wei |
开封市中心医院, 河南 开封 475000 |
Kaifeng Central Hospital, Kaifeng 475000, Henan, China |
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| 张允帅 |
ZHANG Yun-shuai |
开封市中心医院, 河南 开封 475000 |
Kaifeng Central Hospital, Kaifeng 475000, Henan, China |
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| 林有志 |
LIN You-zhi |
开封市中心医院, 河南 开封 475000 |
Kaifeng Central Hospital, Kaifeng 475000, Henan, China |
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| 期刊信息：《中国骨伤》2020年，第33卷，第1期，第15-20页 |
| DOI：10.3969/j.issn.1003-0034.2020.01.004 |
| 基金项目: |
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中文摘要:
目的：分析计算机导航辅助全膝关节置换术对膝骨关节炎患者术中出血量及术后关节功能恢复的影响。
方法：自2015年2月至2017年12月，回顾分析经传统入路全膝关节置换术治疗的65例膝骨关节炎患者作为对照组，同期计算机导航下全膝关节置换术治疗的65例膝骨关节炎患者作为试验组。全部患者术前均表现出膝盖红肿痛、上下楼梯痛、坐起立行时腰部酸痛不适等临床症状，全部患者接受全膝关节置换术治疗，对照组仅为传统入路全膝关节置换，试验组在计算机导航系统下实施全膝关节置换。记录对比两组患者手术相关情况，包括手术时间、住院时间等；分别于术前、术后5 d检测并对比两组血红蛋白、红细胞比容变化情况；计算并对比两组失血情况及术后各时间点引流量，同时记录患者围术期异体输血率及平均输血量；分别于术前，术后6、18个月采用膝关节功能量表（KSS）评价患者膝关节功能恢复情况，同时记录术后感染、下肢静脉血栓等并发症发生率。
结果：全部患者手术成功完成，术后伤口预后情况良好，患者均获得随访，随访时间平均18个月。试验组手术时间长于对照组，住院时间短于对照组（P<0.05）；术后5 d，两组血红蛋白、红细胞比容均较术前降低，但试验组降低不及对照组（P<0.05）；试验组术中失血量、总失血量、隐性失血量、术后10、24 h引流量均少于对照组，异体输血率低于对照组，输血量少于对照组（P<0.05）；两组术后各时点KSS评分均较术前升高，但试验组升高幅度高于对照组（P<0.05）；两组术后均有并发症发生，组间并发症发生率比较，差异无统计学意义（P>0.05）。
结论：在计算机导航指导下开展全膝关节置换术，较单一全膝关节置换虽延长了手术时间，但更利于减少患者围术期失血量，患者术后异体输血率降低，关节功能恢复情况理想，且并发症少，安全可靠。 |
| 【关键词】关节成形术,置换,膝 计算机导航 失血,手术 |
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| Effect of total knee arthroplasty under computer navigation on intraoperative blood loss and joint function recovery |
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ABSTRACT
Objective: To analyze the effect of computer navigation assisted total knee arthroplasty on intraoperative hemorrhage and postoperative joint function recovery in patients with knee osteoarthritis.
Methods: From February 2015 to December 2017,65 patients with knee osteoarthritis treated by traditional total knee arthroplasty were retrospectively analyzed as the control group and 65 patients with knee osteoarthritis treated by total knee arthroplasty under computer navigation as the experimental group. Before operation,all patients showed red swelling pain of knee,pain of going up and down stairs,and pain and discomfort of waist when sitting up and standing up. All patients were treated with total knee arthroplasty. The control group was treated with traditional total knee arthroplasty,and the experimental group was treated with total knee arthroplasty under the computer navigation system. The operation related conditions of the two groups were recorded and compared including the operation time and hospitalization time;the changes of hemoglobin and hematocrit of the two groups were detected and compared before and 5 days after the operation;the blood loss of the two groups and the induced flow at each time point calculated and compared after the operation,and the perioperative allogeneic blood transfusion rate and average blood transfusion volume of the patients were recorded;The joint function scale(KSS) was used to evaluate the recovery of knee joint function before the operation,6 and 18 months after the operation respectively and to record the incidence of postoperative infection,lower extremity venous thrombosis and other complications.
Results: All the patients were successfully operated and the prognosis of the wound was good. All the patients were followed up for an average of 18 months. The operation time of the experimental group was longer than that of the control group,and the hospitalization time was shorter than that of the control group(P<0.05);the KSS score of the two groups at each time point after operation was higher than that before operation,but the increasing range of the test group was higher than that of the control group(P<0.05);there was no significant difference between the two groups in the incidence of complications (P>0.05).
Conclusion: Under the guidance of computer navigation,total knee arthroplasty can prolong the operation time compared with single total knee arthroplasty,but it is more conducive to reduce perioperative blood loss,reduce the rate of postoperative allogeneic blood transfusion,ideal recovery of joint function,less complications,safety and reliability. |
| KEY WORDS Arthroplasty,replacement,knee Surgery,computer-assisted Blood loss,surgical |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 于清波,鄂正康,辛红伟,张允帅,林有志.计算机导航下全膝关节置换术对术中出血量及关节功能恢复的影响[J].中国骨伤,2020,33(1):15~20 |
| 英文格式: | YU Qing-bo,E Zheng-kang,XIN Hong-wei,ZHANG Yun-shuai,LIN You-zhi.Effect of total knee arthroplasty under computer navigation on intraoperative blood loss and joint function recovery[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(1):15~20 |
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