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[1]何少奇,湯呈宣,唐小君,等.頸后路單開門椎管擴(kuò)大成形跳躍式與連續(xù)式微型鈦板內(nèi)固定術(shù)治療多節(jié)段脊髓型頸椎病的對(duì)比研究[J].中醫(yī)正骨,2019,31(04):8-16.
　ZHOU Hongxing,YI Weiguo,ZHANG Baojian,et al.Application of tourniquets to primary unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2019,31(04):8-16.
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頸后路單開門椎管擴(kuò)大成形跳躍式與連續(xù)式微型鈦板內(nèi)固定術(shù)治療多節(jié)段脊髓型頸椎病的對(duì)比研究()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期數(shù):
2019年04期
頁碼:
8-16
欄目:
出版日期:
2019-04-30

文章信息/Info

Title:
Application of tourniquets to primary unicompartmental knee arthroplasty for treatment of medial compartment knee osteoarthritis
作者:
何少奇; 湯呈宣; 唐小君; 戴鳴海
(瑞安市人民醫(yī)院,浙江 瑞安 325200)
Author(s):
ZHOU Hongxing; YI Weiguo; ZHANG Baojian; LAN Yubin; CHENG Xiaohui; WANG Yongchao; JIANG Zukang; YUAN Xiangsheng
The 152nd Central Hospital of PLA,Pingdingshan 467000,Henan,China
關(guān)鍵詞:
頸椎病;  椎管;  椎管成形術(shù);  鈦板;  跳躍式固定;  連續(xù)式固定;  臨床試驗(yàn)
Keywords:
osteoarthritis; knee;  arthroplasty; replacement; knee;  tourniquets;  clinical trial
文獻(xiàn)標(biāo)志碼:
A
摘要:
目的:比較頸后路單開門椎管擴(kuò)大成形跳躍式與連續(xù)式微型鈦板內(nèi)固定術(shù)治療多節(jié)段脊髓型頸椎病的臨床療效及安全性。方法:回顧性分析120例多節(jié)段脊髓型頸椎病患者的病例資料,其中采用頸后路單開門椎管擴(kuò)大成形跳躍式微型鈦板內(nèi)固定治療60例(跳躍式固定組),C<sub>3</sub>、C<sub>5</sub>、C<sub>7</sub>開門側(cè)予以Arch鈦板固定,C<sub>4</sub>、C<sub>6</sub>開門側(cè)予以傳統(tǒng)縫線固定; 采用頸后路單開門椎管擴(kuò)大成形連續(xù)式微型鈦板內(nèi)固定60例(連續(xù)式固定組),C<sub>3</sub>～C<sub>7</sub>開門側(cè)均予以Arch鈦板固定。
Abstract:
Objective:To explore the applied values and safety of tourniquets in primary unicompartmental knee arthroplasty(UKA)for treatment of medial compartment knee osteoarthritis(KOA).Methods:Ninety patients with medial compartment KOA were enrolled in the study and were randomly divided into tourniquet group and non-tourniquet group by using random digits table,45 cases in each group.All patients in the 2 groups were treated with UKA,and the pneumatic tourniquets were applied to patients of tourniquet group at thigh root in the surgery,while no pneumatic tourniquets were applied to patients of non-tourniquet group.The operative time,knee pain visual analogue scale(VAS)scores,American knee society scores(KSS)and complications were recorded and compared between the 2 groups respectively,and the tourniquet reactions were observed in tourniquet group.Results:The operative time was shorter in tourniquet group compared to non-tourniquet group(61.00+/-3.24 vs 70.00+/-2.87 min,<i>t=</i>4<i>.</i>854<i>,P</i>=0.002).The lower limbs pain(3)and drop of blood pressure after releasing the tourniquet(38)were found during the surgery in patients of tourniquet group.The lower limbs pain(2),thigh pain(15),lower limb numbness(17)and tension blisters at the root of thigh(1)were found at postoperative hour 6.The thigh pain(8),lower limb numbness(2)and tension blisters at the root of thigh(8)were found at postoperative hour 24,and thigh pain(1)was found at postoperative hour 48.There was no interaction between time factor and group factor in knee pain VAS scores(<i>F=</i>23<i>.</i>846<i>,P=</i>0.170).There was no statistical difference in knee pain VAS scores between the 2 groups,in other words,there was no group effect(<i>F=</i>10<i>.</i>589<i>,P</i>=0.543).There was statistical difference in knee pain VAS scores between different timepoints before and after the surgery,in other words,there was time effect(<i>F=</i>14<i>.</i>286<i>,P</i>=0.000).The knee pain VAS scores presented a time-dependent decreasing trend in both of the 2 groups,and the 2 groups were consistent with each other in the decreasing trend of knee pain VAS scores(6.87+/-1.01,6.14+/-1.21,2.34+/-1.82,1.96+/-1.34,1.35+/-0.73 points,<i>F=</i>1<i>.</i>162<i>,P</i>=0.000; 7.03+/-1.24,5.87+/-1.57,2.41+/-1.65,2.08+/-1.25,1.24+/-0.68 points,<i>F=</i>8<i>.</i>023<i>,P</i>=0.000).There was no interaction between time factor and group factor in KSS scores(<i>F=</i>29<i>.</i>642<i>,P=</i>0.080).There was no statistical difference in KSS scores between the 2 groups,in other words,there was no group effect(<i>F=</i>15<i>.</i>637<i>,P</i>=0.642).There was statistical difference in KSS scores between different timepoints before and after the treatment,in other words,there was time effect(<i>F=</i>31<i>.</i>345<i>,P</i>=0.000).The KSS scores presented a time-dependent increasing trend in both of the 2 groups,and the 2 groups were consistent with each other in the increasing trend of KSS scores(35.4+/-4.61,52.6+/-5.16,73.7+/-4.81,85.6+/-5.32,89.2+/-4.29 points,<i>F=</i>34<i>.</i>284<i>,P=</i>0.000; 34.9+/-5.82,51.4+/-4.85,72.9+/-5.03,84.9+/-4.86,90.1+/-3.53 points,<i>F=</i>40<i>.</i>129<i>,P</i>=0.000).No complications such as lower extremity deep venous thrombosis,prosthetic components displacement and peri-prosthetic fracture were found in both of the 2 groups.Conclusion:Application of tourniquets can shorten the operation time in primary UKA for treatment of medial compartment KOA with few complications.Although tourniquet reactions at different degrees may occur after the surgery,they have no obvious effect on knee pain relief and knee function recovery.

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更新日期/Last Update: 2019-10-09