人工膝关节置换术后切口愈合不良的影响因素分析

发布时间：2018-11-14 17:07

【摘要】：目的观察人工膝关节置换术(total knee arthroplasty,TKA)后切口愈合情况,探讨影响切口愈合的因素。方法回顾性分析第三军医大学新桥医院2014年246例初次接受TKA患者的临床资料,对其一般资料(年龄、性别、体质量指数,术前情况如基础疾病、术前总蛋白、术前白蛋白、术前血红蛋白等)及术后指标(术后总蛋白、术后白蛋白、术后血红蛋白等)进行对比分析。采用SPSS 20.0统计软件进行单因素分析及多因素Logistic回归分析。结果发生愈合延迟等切口愈合不良情况的患者17例(6.91%),单因素分析显示,患者年龄、术前总蛋白及白蛋白、止血带压力、术后第1天总蛋白及白蛋白与切口愈合不良有关(P0.05);Logistic回归分析结果显示,TKA患者术前白蛋白(OR=0.703,95%CI=0.552~0.895,P=0.004)、术后第1天白蛋白(OR=0.762,95%CI=0.623~0.933,P=0.008)为其保护因素,止血带压力(OR=2.695,95%CI=1.971~7.482,P=0.047)为其危险因素。结论影响TKA患者术后切口愈合的因素较多,应密切关注止血带压力和营养学指标(术前及术后白蛋白水平)。
[Abstract]:Objective to observe the wound healing after artificial knee arthroplasty (total knee arthroplasty,TKA) and to explore the factors influencing wound healing. Methods the clinical data of 246 patients with TKA in Xinqiao Hospital of the third military Medical University in 2014 were retrospectively analyzed. The general data (age, sex, body mass index, preoperative condition such as basic disease, preoperative total protein, preoperative albumin) were analyzed retrospectively. Preoperative hemoglobin and postoperative indexes (postoperative total protein, postoperative albumin, postoperative hemoglobin, etc.) were compared and analyzed. Single factor analysis and multivariate Logistic regression analysis were carried out with SPSS 20.0 software. Results there were 17 cases (6.91%) with poor healing of incision such as delayed healing. Univariate analysis showed that age, preoperative total protein, albumin, tourniquet pressure, and so on. On the first day after operation, total protein and albumin were associated with poor wound healing (P0.05). Logistic regression analysis showed that albumin (OR=0.703,95%CI=0.552~0.895,P=0.004) before operation and albumin (OR=0.762,95%CI=0.623~0.933,P=0.008) on the first day after operation were the protective factors in patients with TKA. Tourniquet pressure (OR=2.695,95%CI=1.971~7.482,P=0.047) was a risk factor. Conclusion there are many factors influencing wound healing in patients with TKA, so we should pay close attention to tourniquet pressure and nutritional parameters (preoperative and postoperative albumin levels).
【作者单位】：第三军医大学护理学院基础护理学教研室;第三军医大学新桥医院骨科;第三军医大学新桥医院护理部;
【基金】：国家自然科学基金面上项目(81171720)~~
【分类号】：R687.4

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