Total knee arthroplasty with or without plugging femoral intramedullary positioning hole
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NSTL
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[目的]探究全膝关节置换术(total knee arthroplasty,TKA)中股骨髓内定位孔封堵对围术期失血量的影响.[方法]2019年10月-2021年10月就诊于本院拟行初次单侧TKA的60例患者纳入本研究,随机将患者分为两组.其中,30例术中使用骨塞将股骨髓内定位孔进行封堵,另外30例未将定位孔进行封堵,其余两组操作皆相同.比较两组早期临床及检验结果.[结果]两组手术时间、切口长度、术后首次下床时间、住院时间差异均无统计学意义(P＞0.05).封堵组在术中出血量[(278.7±41.3)ml vs(319.7±50.9)ml,P＜0.001]、总失血量[(1 155.7±260.4)mlvs(1 312.0±228.3)ml,P=0.016]均显著少于开放组.平均随访时间(10.6±2.4)个月,术前两组间VAS、HSS评分差异均无统计学意义(P＞0.05),封堵组术后1 d[(6.7±0.4)vs(7.1±0.5),P=0.010]、7 d 的 VAS 评分[(5.4±0.6)vs(6.3±0.6),P＜0.001],及术后1d 的HSS评分[(53.7±4.9)vs(49.6±3.7),P＜0.001]均显著优于开放组.术前两组患者的Hb、Hct、ESR、CRP差异均无统计学意义(P＞0.05).封堵组术后1 d的Hb、Hct及术后3～5 d的Hct、ESR、CRP均显著优于开放组(P＜0.05).[结论]用骨塞封堵股骨髓内定位孔是一种简单且可十分有效地减少初次TKA失血的方法.
[Objective]To compare the early outcomes of total knee arthroplasty(TKA)with or without plugging femoral intramedullary positioning hole.[Methods]From October 2019 to October 2021,a total of 60 patients who were undergoing initial unilateral TKA were in-cluded in this study and randomly divided into two groups.Among them,30 patients used bone plug to seal the femoral intramedullary po-sitioning hole,while other 30 patients had not the hole sealed,and the other surgical manipulations were the same in both groups.The ear-ly clinical and blood test results of the two groups were compared.[Results]Although there were no significant differences in operation time,incision length,postoperative walking time,and hospital stay between the two groups(P＞0.05),the plugging group proved significant-ly superior to the non-plugging group in terms of intraoperative blood loss[(278.7±41.3)ml vs(319.7±50.9)ml,P＜0.001]and total blood loss[(1 155.7±260.4)ml vs(1 312.0±228.3)ml,P=0.016].The mean follow-up time was of(10.6±2.4)months.There was no significant dif-ference in VAS and HSS scores between the two groups before surgery(P＞0.05),however,the plugging group was significantly better than the non-plugging group in terms of VAS score at 1 day[(6.7±0.4)vs(7.1±0.5),P=0.010]and 7 day[(5.4±0.6)vs(6.3±0.6),P＜0.001]postop-eratively,and HSS score[(53.7±4.9)vs(49.6±3.7),P＜0.001]1 day after surgery.With regard to blood test,there were no significant differ-ences in Hb,Hct,ESR and CRP between the two groups before surgery(P＞0.05),the plugging group was significantly superior to the non-plugging groups regarding Hb,Hct and Hct,ESR and CRP 1,3 and 5 days after surgery(P＜0.05).[Conclusion]Bone plug used to seal the femoral intramedullary positioning hole is simple,but efficient method to reduce blood loss in primary TKA.
total knee arthroplastypositioning holepluggingperioperative blood loss
NETL
NSTL
万方数据
