初次全膝关节置换手术相关并发症的原因分析

The analysis of the causes of primary total knee replacement surgery related complications

目的探讨膝关节置换术手术相关并发症的原因,并提供相应策略.方法：2007 年6 月-2012 年6 月,采用人工全膝关节置换治疗的144 例198 膝的患者,17 名患者出现手术相关并发症,发病率为12.2%,其中下肢深静脉血栓形成并发症5 例;5 例为伤口相关并发症;3 例局部急性局部感染;1 例腓总神经麻痹;3 例膝关节僵硬.结果：17 例手术相关并发症患者中,5 例下肢深静脉血栓形成患者通过溶栓抗凝得到好转;5 例伤口相关并发症通过换药清创得到治愈;3 例急性局部感染病例通过翻修抗炎获得好转;1 例腓总神经麻痹患者给予营养神经2 个月获得好转,症状改善;3 例僵硬患者通过康复锻炼及手法松解恢复功能.结论：全膝关节置换手术并发症影响患者膝关节功能,重视并发症原因,并对其合理治疗,可使患者获得良好收益.

Objective:To investigate the causes of total knee arthroplasty(TKA) surgery related complications, and treatment for complications to provide the corresponding strategies.Methods: From June 2007 to August 20012, 144 cases,198 knees; underwent primary TKA using standard midline incision and medial parapatellar arthrotomy. There were 55 males(65 knees) and 89 females(133 knees) aged 59-85 years old(average 63.5 years old). The duration of disease was 6-11 years., average 8.3 years. There are 3 patients lost to follow-up. There were 17 patients with complications related to the operation, the incidence was 12.2%, including 5 cases lower extremity deep vein thrombosis complications; 5 cases for wound complications; 3 cases of partial acute local infection; 1 case peroneal nerve dysfunction; 3 cases of knee joint stiffness. Results: In 17 patients, 5 patients with lower extremity deep venous thrombosis had been get better by thrombolysis anticoagulation; 5 cases of wound complications associated had been get better by dressing debridement cured; 3 cases of acute local infection cases had been get better by overhaul anti-inflammatory; 1 peroneal nerve dysfunction patients had been get better with nutritional nerve 2 months; 3 patients with stiff had been get better by rehabilitation exercise and release to restore function. Conclusions: Total knee replacement surgery complications had affected knee joint function.To attach great importance to the complications of reason, and the reasonable treatment, could make patients get good returns.