关节镜下膝关节滑膜切除术后患膝肿痛危险因素的Logistic回归分析

Logistic regression for effect factors of postoperative knee pain edema in patients underwent synovectomy via arthroscopy

目的分析导致关节镜下膝关节滑膜切除术后患膝出现肿胀或疼痛的危险因素。方法回顾性分析术后出现患膝肿痛的31个膝关节镜案例共38膝,将病因归为手术操作及患者自身两大因素,并进行二元因素赋值,通过Logistic二元回归分析比较以上因素对并发症的影响。结果经5步回归,发现刨削器误卷入韧带、入路不准确及冲洗液外渗至膝关节周围软组织、关节腔间隙过窄及合并全身性疾病共5个因素为术后膝关节肿痛的危险因素(P均=0.000,模型分类判对率均大于85%)。结论对于合并全身性疾病且关节腔间隙过窄的患者,在关节镜下行滑膜切除时应在选取正确手术入路的前提下,及时吸附冲洗液,并认真避免误伤韧带。

Objective To make logistic regression for factors resulting in postoperative knee pain edema for patients underwent synovectomy via arthroscopy. Methods A retrospective analysis was made and 31 of pain in the knee was recorded the arthroscopic case. Thirty-eight knee operation and the patient＇s own were caused as two factors, and assignment for dual factors, dual by Logistic regression analysis to compare the influence of above factors on the complications. Results By 5 step regression, five factors with the ＂planning machine faults in ligaments, into the road is not accurate and rinses extravasation into the soft tissue around the knee joint, the articular cavity clearance too narrow, merging, systemic disease＂ were found as the factors relating to postoperative pain in the knee joint. Conclusion The combined systemic disease and patients with articular cavity gap too narrow, the downward arthroscopic synovectomy should be on thepremise of selecting the right surgical approach, timely adsorption rinses, and carefully to avoid injured ligaments.