人工全髋关节置换术中应用组织胶水与传统缝合法的比较研究

发布时间：2018-03-10 06:05

本文选题：组织胶水　切入点：人工全髋关节置换术　出处：《中国修复重建外科杂志》2016年12期 　论文类型：期刊论文

【摘要】：目的通过与传统缝合法比较,探讨组织胶水用于人工全髋关节置换术(total hip arthroplasty,THA)的可行性及疗效。方法将2015年1月-10月收治并符合选择标准的159例初次THA患者纳入研究,其中80例(100髋)术中采用可吸收缝合线及组织胶水闭合切口(试验组);79例(100髋)采用传统皮钉闭合切口(对照组)。两组患者性别、年龄、体质量指数、病因等一般资料比较,差异均无统计学意义(P0.05)。记录并比较两组手术时间、住院时间,术后15 d行切口疼痛视觉模拟评分(VAS)、切口愈合评分、切口愈合分级及切口满意度评价。结果两组患者均获随访,随访时间3~6个月,平均4.7个月。试验组手术时间与对照组相比,差异无统计学意义(Z=-0.527,P=0.598);但住院时间较对照组缩短(Z=-2.004,P=0.045)。术后试验组1例(1髋)发生切口渗出,1例(1髋)切口裂开;对照组2例(2髋)发生切口周围红肿,2例(2髋)切口持续渗出,4例(4髋)引流口加压包扎后仍有渗液,1例(1髋)误缝引流管。术后15 d两组VAS评分比较差异无统计学意义(Z=-0.125,P=0.901);但试验组切口愈合评分显著高于对照组(Z=-2.943,P=0.003)。试验组切口甲级愈合98髋、乙级愈合2髋,对照组分别为92髋、8髋,比较差异有统计学意义(χ~2=3.789,P=0.048)。试验组切口满意度评分显著高于对照组(Z=-2.626,P=0.009)。结论与传统缝合法相比,初次THA术中应用组织胶水闭合切口,术后切口并发症发生率低,且操作简便、安全,患者满意度高。
[Abstract]:Objective to explore the feasibility and curative effect of tissue glue in total hip arthroplasty by comparing with traditional suture. Methods from January 2015 to October, 159 primary THA patients who met the selection criteria were included in the study. 80 cases (100 hips) were treated with absorbable suture and tissue glue closed incision (79 cases with 100 hips in the experimental group) with traditional skin nail incision (control group). The general data of sex, age, body mass index, etiology and so on were compared between the two groups. There was no significant difference between the two groups (P 0.05). The operation time, hospital stay, visual analogue score of incision pain, wound healing score, wound healing grade and wound satisfaction were recorded and compared 15 days after operation. Results the patients in both groups were followed up. The follow-up time was 3 ~ 6 months (mean 4.7 months). Compared with the control group, the operation time of the trial group was not significantly different from that of the control group, but the hospitalization time was shorter than that of the control group, but the hospitalization time was shorter than that in the control group. In the control group, 2 cases (2 hips) developed redness around the incision (2 cases (2 hips)) continuous exudation of incision (4 cases (4 hips)) after compression bandaging of drainage orifice, there was still exudate in 1 case (1 hip) missewed drainage tube. There was no difference in VAS score between the two groups 15 days after operation. The score of wound healing in the experimental group was significantly higher than that in the control group (P < 0.05), but the score of wound healing in the experimental group was significantly higher than that in the control group (n = 98), but the score of wound healing in the experimental group was significantly higher than that in the control group (n = 98). Two hips healed in grade B and 92 hips in control group (蠂 ~ 2 / 789), and the difference was statistically significant (蠂 ~ (2 / 2) 3.789). The score of incision satisfaction in the experimental group was significantly higher than that in the control group. Conclusion compared with the traditional suture method, the first time THA operation was performed with glue closed incision, and the wound satisfaction score was significantly higher than that in the control group (P < 0.05). The incidence of postoperative incision complications was low, the operation was simple, safe, and the patient satisfaction was high.
【作者单位】：中国人民解放军总医院骨科;
【分类号】：R687.4

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