关节镜下前交叉韧带重建术后膝关节皮温变化的研究

Study of Skin Temperature Changes in Knee Joints After Arthroscopic Anterior Cruciate Ligament Reconstruction

目的探讨关节镜下前交叉韧带(anterior cruciate ligament,ACL)重建术后膝关节皮温变化的特点。方法2015年7月~2016年10月我院63例ACL重建,检测术前和术后3、6、12周(23例)双侧膝关节及周围皮肤温度,观察术后膝关节肿胀情况。结果健侧膝关节术前膝前方皮温低于膝内侧、膝外侧、髌骨上缘上方10 cm处大腿以及髌骨下缘下方10 cm处小腿皮温(P<0.05)。患侧术前、术后3和6周膝前与膝内侧温差差异有显著性(χ^2=41.608,P=0.000),术后3周患侧膝前和膝内侧温度接近,温差明显小于术前(P=0.000),术后6周温差与术前差异无显著性(P=0.069)。不同时间(术前、术后3和6周)膝前、膝内和外侧和大腿患侧皮温明显高于健侧(P<0.05),小腿患侧和健侧差异无显著性(P>0.05)。术后12周仅39.1%(9/23)的患者双侧膝前温度差>1℃。术后3、6周膝关节肿胀患者较不肿患者膝前温差明显升高(Z=-3.821,P=0.000;t=-5.181,P=0.000)。结论正常膝关节膝前方皮温较低,关节镜下ACL重建术后3、6周时皮温高于健侧,12周时接近正常。

Objective To investigate the characteristics of skin temperature changes in knee joints after arthroscopic anterior cruciate ligament(ACL)reconstruction.Methods From July 2015 to October 2016,the skin temperature of bilateral knee joints and legs were measured at before operation and 3,6 and 12 weeks after operation,and the swelling of knee joints after operation was observed for 63 patients hospitalized with ACL reconstruction.Results The skin temperature of anterior knee joint was lower than that of medial knee,lateral knee,thigh at 10 cm above the patella and leg at 10 cm below the patella(P<0.05).There was a significant difference in the temperature difference between the anterior and medial sides of the knee in different periods of time(χ^2=41.608,P=0.000).At 3 week after operation,the temperature of the anterior knee and medial side of the affected knee were similar,and the temperature difference was smaller significantly than that before operation(P=0.000).There was no significant difference in temperature difference between 6 weeks after operation and before operation(P=0.069).The skin temperature at front,medial and lateral knee and affected side of the thigh was significantly higher than that in the healthy side(P<0.05),but there was no significant difference between the affected side and the healthy side(P>0.05)at before operation and 3,6 weeks after operation.However,at 12 weeks after operation only 39.1%of the patients had a temperature difference greater than 1℃,and the mean temperature difference was less than 1℃.The temperature difference of the anterior knee in patients with knee swelling was significantly higher than that in patients without knee swelling at 3 and 6 weeks after operation(Z=-3.821,P=0.000;t=-5.181,P=0.000).Conclusions The anterior skin temperature in the normal knee joint is lower than that in medial knee and lateral knee.The skin temperature of the ACL reconstruction under arthroscope is higher than that of the healthy knee at 3 and 6 weeks,and is close to normal at 12 weeks.