生物骨科材料与临床研究2018，Vol.15Issue(3)：14-17,4.DOI:10.3969/j.issn.1672-5972.2018.03.004
不同程度的下肢动脉钙化对全膝关节置换术的伤口并发症分析
Wound complications analysis of total knee arthroplasty patients with different degrees of vascular calcifications
丁冉 1王佰亮 1史振才 1王卫国 1郭万首 1岳德波 1孙伟 1程立明 1刘朝晖 1张念非1
作者信息
- 1. 中日友好医院骨科一部,北京,100029
- 折叠
摘要
Abstract
Objective The aim of this study was to discuss whether TKA patients with preexisting radiographic evidence of vascular calcifications had a higher risk of wound ischemic complications. Methods In this retrospective analysis, all patients who had undergone primary TKA in the period 2015 ～ 2016 with intraoperative use of a tourniquet were included. Vascular calcifications seen on the preoperative radiograph were classified as intimal-type and medial-type calcifications and no calcifications. The correlation analysis of perioperative ischemic complications and calcifications was done. Results There are 437 patients with 577 knees were included. Vascular calcifications were seen in 96 knees (medial type: n=74 knees, 64 patients; intimal type: n=22 knees, 20 patients). Major ischemic complications such as arterial thrombosis were not seen. The rate of minor ischemic complications such as poor healing of superficial wound was significantly elevated in patients with intimal-type calcifications (5. 40％) when compared to patients with medial-type calcifications(0％) and those without (1. 25％, P=0. 032). Multiple Logistic regression analysis revealed the factor most associated with the increase risk for ischemic complications was intimal-type calcifications (OR=1. 367, 95％CI: 1. 152-1. 888). Conclusion The rate of minor ischemic complications was obviously elevated in the patient group with intimal artery calcifications. We recommend high alertness to the presence of calcifications on preoperative radiographs. In patients with intimal artery calcifications, standardized application of tourniquet should not be ignored. Intraoperative soft tissue management should be very careful and postoperative vascular status should be monitored closely.关键词
血管钙化/缺血并发症/全膝关节置换术Key words
Ischemic complications/Vascular calcifications/Total knee arthroplasty分类
医药卫生引用本文复制引用
丁冉,王佰亮,史振才,王卫国,郭万首,岳德波,孙伟,程立明,刘朝晖,张念非..不同程度的下肢动脉钙化对全膝关节置换术的伤口并发症分析[J].生物骨科材料与临床研究,2018,15(3):14-17,4.
