膝关节置换术后体温升高与手术操作的相关性分析

The correlation analysis between the postoperative elevated body temperature and surgical operations for the knee replacement surgery patients

目的探讨膝关节置换术后体温升高与手术操作的相关性。方法选择在2008年3月到2014年3月收治的骨关节炎患者72例,均给予膝关节置换术。观察术后体温升高与预后情况,同时对患者的基础资料、疾病资料、手术资料与术后资料进行详细调查与相关性分析。结果所有患者都顺利完成手术,术后体温升高9例,发生率为18.8%。术后患者血红蛋白值明显低于术前,而ESR与CRP值明显高于术前,差异有统计学意义(P<0.05)。多元Logistic回归分析结果显示止血带应用、"鸡尾酒"镇痛、氨甲环酸应用、夹闭引流管、棉垫加压包扎是影响术后体温升高的独立危险因素(P<0.05)。Person相关分析结果显示氨甲环酸应用、"鸡尾酒"镇痛与止血带应用与术后体温升高的发生有明显负向相关性(P<0.05)。术后3个月进行评定,患者的Hss评分为92.87±6.22分,明显高于术前的44.72±5.01分(P<0.05)。结论膝关节置换术后体温升高在临床上比较常见,多伴随有ESR、血红蛋白与CRP的异常,氨甲环酸应用、"鸡尾酒"镇痛与止血带应用与术后体温升高的发生有明显相关性,要积极进行手术改进操作。

Objective To investigate the correlation between the postoperative elevated body temperature and surgical operations for the knee replacement surgery patients. Methods 72 osteoarthritis patients from March 2008 to March 2014 in our hospital were selected into this study. All patients were given the active knee replacement surgery. The postoperative body temperature situation and prognosis were observed, nbsp;while the patientsˊinformation disease data,surgical data and postoperative data were given detailed survey and correlation analyzed. Results All patients were successfully completed surgery,there were 9 patients were postoperative elevated body temperature,the rate was 18. 8%. And the postoperative hemoglobin value was significantly lower than the preoperative,while the postoperative ESR and CRP values were significantly higher than the preoperative（ P 〈0. 05）. Multivariate logistic regression analysis showed that tourniquet application,＆quot;cocktail ; analgesic,tranexamic acid application,clipping drainage tube,pad pressure bandage were the independent risk factor for postoperative body temperature（ P 〈0. 05）. Person correlation analysis showed that tranexamic acid applications ＂cocktail＂ of postoperative analgesia and tourniquet application were negative to the occurrence of postoperative elevated body temperature（ P 〈0. 05）. Evaluated after three months,the patientˊs Hss score was 92. 87 ± 6. 22 points that were significantly higher than the preoperative 44.72 ±5.01 scores（P 〈0.05）. Conclusion The postoperative elevated body tem-perature in the knee replacement is relatively common in clinical practice,and is more accompanied by hemoglobin ,ESR,CRP abnormal,tranex-amic acid applications,＂cocktail＂ analgesic and tourniquet application are more related to the postoperative elevated body temperature,we should actively improve surgical operation.