膝关节置换术后皮温的相关研究与分析

发布时间：2018-05-29 20:12

  本文选题：骨性关节病 + 全膝关节置换术　； 参考：《青海大学》2017年硕士论文

【摘要】：目的:探讨本地区膝关节置换术后切口周围温度变化趋势及规律;并了解皮温变化与相关实验室炎性指标的关系。方法:测量膝关节置换(TKA)患者术前1天,术后第1天、第3天、第5天、第7天、第14天、第4周、第12周、第24周、第48周患者体温、双侧膝关节皮肤温度。并同时监测患者术前1天,术后第1天、第3天、第5天、第7天、第4周、第12周、第24周的C反应蛋白(CRP)、红细胞沉降率(ESR)、白细胞介素-6(IL-6),降钙素原(PCT)。结果:术前双侧膝关节皮温相比无统计学差异(P0.05);术后术侧及健侧第1、3、5、7、14天、4周、12周、24周相比有统计学差异(P0.05)。本研究表明TKA术后双侧膝关节皮肤温度均较术前升高,术侧温度升高大于非手术侧,术后3-7天双侧皮肤温差较大,双膝关节皮温差在术后随时间推移逐渐缩小,皮温差在术后24周以后基本没有差别,术后48周双侧皮温无差异。CRP、ESR、IL-6、PCT在术后升高,虽然峰值出现的时间先后不同,但术后3-7天以上炎性指标血浆浓度升高明显,术后随时间推移基本降至正常水平的时间不同。结论:切口周围皮肤温度的升高多考虑是TKA术后手术创伤引起的,随着术后炎性反应逐渐消退切口皮肤温度逐渐和对侧相同。术后CRP、ESR、IL-6、PCT变化的趋势与皮肤温度变化的趋势基本一致。而对于本地区病例而言高于本研究的TKA术后皮温变化水平,要引起临床医生的重视,警惕感染的发生。
[Abstract]:Objective: to investigate the trend and regularity of the changes in the peripheral temperature of the incision after knee arthroplasty, and to understand the relationship between the changes of the skin temperature and the laboratory inflammatory indexes. Methods: the body temperature and skin temperature of bilateral knee joint were measured 1 day before operation, 1 day, 3 days, 5 days, 7 days, 14 days, 4 weeks, 12 weeks, 24 weeks and 48 weeks of knee arthroplasty. At the same time, the C-reactive protein (CRP), erythrocyte sedimentation rate (RSR), interleukin-6 (IL-6) IL-6 and procalcitonin (PCT) were monitored 1 day before operation, 1 day, 3 days, 5 days, 7 days, 4 weeks, 12 weeks and 24 weeks after operation. Results: there was no significant difference in the skin temperature of bilateral knee joint before operation (P 0.05), and there was a significant difference between the operation side and the normal side (P 0.05). This study showed that the skin temperature of the bilateral knee joint after TKA was higher than that of the preoperative, and the skin temperature difference of the bilateral knee joint was larger than that of the non-operative side. The skin temperature difference of the knee joint decreased gradually with time after operation. There was no difference in skin temperature after 24 weeks postoperatively, but there was no difference in skin temperature between the two sides at 48 weeks after operation. Although the peak value appeared at different time, the plasma concentration of inflammatory markers above 3-7 days after operation was obviously increased. After the operation, the time of basically falling to the normal level was different with the passage of time. Conclusion: the increase of skin temperature around the incision is mainly caused by the wound after TKA, and the skin temperature of the incision gradually decreases with the inflammatory reaction after the operation and is the same as that of the contralateral side. After operation, the trend of PCT change was consistent with that of skin temperature. However, the change level of skin temperature in this area is higher than that in this study, so clinicians should pay attention to it and be alert to the occurrence of infection.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687.4

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