滑膜切除对全膝关节置换出血及临床效果的影响

Influeding of Synovetomy for Total Knee Replacememt Bleeding and Clinical Effect

目的:为了探讨单纯膝关节骨关节炎(OA)患者膝关节表面置换术(TKR)中滑膜切除对围手术期失血量及术后功能评分影响。方法:自2011年2月至2014年3月,对符合标准的187例OA患者行TKR,患者随机分两组,其中一组行滑膜切除。手术时间、住院时间、隐性失血、引流量、输血率、术后3天膝关节活动范围纳入评估指标。术后4周和12月随访VAS疼痛评分,KSS功能评分,髌骨浮沉试验。结果:滑膜切除组隐性失血量、平均引流量、平均手术时间(p<0.05)均显著高于对照组。余统计参数无明显差异。结论:TKR+滑膜切除对OA患者没有优势,且增加了失血量及手术时间。

Objective：To compare the effect of TKR in conjunction with synovectomy and TKR at the time of the surgery on bleed- ing, post-operative pain, clinical and functional outcomes up to 12 months after TKR in patients with primary OA.Methods Between September 2010 and September 2011, a total of 187 patients with primary OA undergoing TKR were included in the study.The patients were divided into two groups according to a random number table generated by a computer ,one group patients with synovectomy. The duration of surgery,hospitalization period, concealed bleeding, drainage volume, blood transfusion rate and range of movement of the knee at three days after the operation were analyzed. Patients were followed up at four weeks and 12 months after their operation, and a visual analogue score （VAS） for pain, Knee Society score （KSS） and a patellar ballottement test were compared between the groups.Re- suits The mean amount of concealed bleeding and the mean drainage volume was higher in the synovectomy group compared with the control group （ p〈0.05）. There were no significant differences in statistically significant differences in other measured parameters. Conclusion We concluded that synovectomy confers no clinical advantages in TKR for primary OA while subjecting patients to higher levels of bleeding and longer operating times.