[1]何少奇,汤呈宣,唐小君,等.颈后路单开门椎管扩大成形跳跃式与连续式微型钛板内固定术治疗多节段脊髓型颈椎病的对比研究[J].中医正骨,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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颈后路单开门椎管扩大成形跳跃式与连续式微型钛板内固定术治疗多节段脊髓型颈椎病的对比研究()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第31卷
期数:
2019年04期
页码:
8-16
栏目:
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; 汤呈宣; 唐小君; 戴鸣海
(瑞安市人民医院,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
关键词:
颈椎病;  椎管;  椎管成形术;  钛板;  跳跃式固定;  连续式固定;  临床试验
Keywords:
osteoarthritis; knee;  arthroplasty; replacement; knee;  tourniquets;  clinical trial
文献标志码:
A
摘要:
目的:比较颈后路单开门椎管扩大成形跳跃式与连续式微型钛板内固定术治疗多节段脊髓型颈椎病的临床疗效及安全性。方法:回顾性分析120例多节段脊髓型颈椎病患者的病例资料,其中采用颈后路单开门椎管扩大成形跳跃式微型钛板内固定治疗60例(跳跃式固定组),C<sub>3</sub>、C<sub>5</sub>、C<sub>7</sub>开门侧予以Arch钛板固定,C<sub>4</sub>、C<sub>6</sub>开门侧予以传统缝线固定; 采用颈后路单开门椎管扩大成形连续式微型钛板内固定60例(连续式固定组),C<sub>3</sub>～C<sub>7</sub>开门侧均予以Arch钛板固定。
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