全膝置换术中截骨飞溅物防护的研究

A study on the protection of spatters from osteotomy during total knee arthroplasty

[目的]评估全膝置换术中两种防护方法对截骨飞溅物的防护效果。[方法]选择本院2019年1月—2019年11月行全膝置换术(total knee arthroplasty,TKA)的71例患者(99膝)为研究对象,采用随机数字法将患者分为3组,每组33膝。在术中截骨时,分别采用无防护、玻璃板防护和"帐篷"防护,计量各类手术人员罩上飞溅油滴数。[结果]三组间比较,主刀、一助、二助和三助的面部油滴计量依次为,无防护组>玻璃板组>帐篷组,各类人员三组间差异均有统计学意义(P<0.05)。各类人员间比较,玻璃板组和账蓬组面部油滴计量依次为主刀>一助>二助和三助;两两比较,主刀面部油滴计量显著大于一助、二助和三助(P<0.05),一助面部油滴计量显著小于主刀,显著大于二助和三助(P<0.05),但是二助与三助间面部油滴计量的差异无统计学意义(P>0.05)。[结论]:使用玻璃板和"帐篷"防护均可显著降低手术人员面部接触截骨飞溅物的风险,软质"帐篷"防护效果更佳,同时无需额外花费、简单易行。

[Objective]To evaluate the protective effect of two protective methods on spatters from osteotomy in total knee arthroplasty.[Methods]A total of 99 knees undergoing total knee arthroplasty(TKA)in our hospital from January 2019 to November 2019 were selected as the research objects,and divided into 3 groups by random number method,with 33 knees in each group.During the intraoperative osteotomy,the unprotected,sheet glass protection and"tent"protection were used separately in the corresponding group,and number of splashed oil drops on face mask of various surgical personnel was measured and compared.[Results]Comparing among the three groups,the measurement of facial oil drops for the surgeon,the first assistant,the second assistant and the third assistant all were ranked up-down in the order of non-protection group>sheet glass group>tent group with statistically significant differences among the three groups of all the personnel(P<0.05).Comparing various types of personnel,facial oil drop measurements in the three groups arranged in the sequence of surgeon>first assistant>second assistant and third assistant.In term of pairwise comparison,the surgeon had facial oil drop measurement significantly greater than that of first assistant,second assistant and third assistant(P<0.05).The amount of facial oil droplets in the first assistant was significantly smaller than that of the surgeon,and significantly greater than that of the second assistant and the third assistant(P<0.05),but there was no significant difference in the amount of facial oil drops between the second assistant and the third assistant(P>0.05).[Conclusion]The use of sheet glass and"tent"protection do significantly reduce the risk of the surgical staff’s face contact with osteotomy splashes,and the soft"tent"has a better protective effect,which is simple and easy to implement without additional cost.