中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (15): 2331-2335.doi: 10.3969/j.issn.2095-4344.2017.15.007

• 人工假体 artificial prosthesis • 上一篇    下一篇

高血压对人工股骨头置换后伤口延迟愈合的影响

刘国印,贾小宝,吴伟华,孙小草,顾洁琼,陈建民   

  1. 南京中医药大学附属八一医院骨科,江苏省南京市   210002
  • 出版日期:2017-05-28 发布日期:2017-06-07
  • 通讯作者: 陈建民,硕士,主任医师,解放军第八一医院骨科,江苏省南京市 210002
  • 作者简介:刘国印,男,1987 年生,江苏省徐州市人,汉族,2014 年南京大学毕业,硕士,医师,主要从事关节外科方面的研究。
  • 基金资助:

    南京市科技计划项目(201503007);南京军区科技创新项目(15ZD020)

Impact of hypertension on delayed wound healing after femoral head replacement

Liu Guo-yin, Jia Xiao-bao, Wu Wei-hua, Sun Xiao-cao, Gu Jie-qiong, Chen Jian-min   

  1. Department of Orthopedics, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, Jiangsu Province, China
  • Online:2017-05-28 Published:2017-06-07
  • Contact: Chen Jian-min, Master, Chief physician, Department of Orthopedics, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, Jiangsu Province, China
  • About author:Liu Guo-yin, Master, Physician, Department of Orthopedics, Bayi Hospital Affiliated to Nanjing University of Chinese Medicine, Nanjing 210002, Jiangsu Province, China
  • Supported by:

     the Science and Technology Plan Program of Nanjing City, No. 201503007; the Science and Technology Innovation Project of Nanjing Military Area, No. 15ZD020

摘要:

文章快速阅读:

 
 

 

文题释义:
伤口持续渗出:纱布充分浸润,或单一伤口纱布表面浸润面积> 2 cm×2 cm 。
伤口延迟愈合:在临床上,伤口愈合后拆线的基本规律大致如下:头面部四五天拆线,胸腹部七八天拆线,腰背部10-12 d拆线,四肢关节部14 d拆线。若患者的伤口在上述时间内未能完全愈合,这在医学上被称为伤口延迟愈合,即伤口愈合时间>14 d,伤口持续渗出3 d以上,或伤口边缘分离宽度>1 cm,长度> 2 cm。
 
摘要
背景:目前关于关节置换的文献报道目前大多侧重于其远期并发症的原因与对策,而对术后近期并发症如伤口持续渗出和延迟愈合的原因关注甚少。有高血压病的患者行髋关节置换后伤口持续渗出和延迟愈合的发生率是否高于血压正常患者国内外尚无相关报道。
目的:明确人工股骨头置换后伤口持续渗出和延迟愈合与高血压之间的关系。
方法:回顾性分析205例老年股骨颈骨折患者资料,所有患者均接受人工股骨头置换术治疗;根据《中国高血压防治指南2010》中的高血压诊断标准分为高血压组和对照组,主要比较两组患者关节置换中失血量、置换后失血量、伤口持续渗出时间、伤口裂开和伤口延迟愈合发生率是否有差异,分析高血压与伤口渗出和延迟愈合的关系。
结果与结论:①高血压组平均收缩压为153.55 mm Hg,对照组为128.82 mm Hg,差异有显著性意义(P < 0.05);②两组患者年龄、性别、关节置换前MNA-SF营养风险评分、合并糖尿病例数、体质量指数,以及关节置换中和置换后失血量差异均无显著性意义(P > 0.05);③高血压组患者伤口持续渗出时间为4.03 d,对照组为2.08 d,差异有显著性意义(P < 0.05);④高血压组患者的伤口延迟愈合发生率明显高于对照组(P < 0.05);⑤结果说明,高血压能够增加关节置换术后伤口持续渗出和延迟愈合发生率的风险,是伤口延迟愈合的重要影响因素之一。

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程
ORCID: 0000-0003-1069-8580(陈建民)

关键词: 骨科植入物, 人工假体, 股骨颈骨折, 人工股骨头置换, 伤口渗出, 伤口延迟愈合

Abstract:

BACKGROUND: At present, most of the literature on joint replacement focus on the causes and countermeasures of long-term complications, but seldom focuses on causes of postoperative short-term complications, such as wound exudation and delayed union. Whether the incidence of sustained exudation and delayed wound healing in patients with hypertension after hip replacement is higher than that in patients with normal blood pressure is not reported at present.

OBJECTIVE: To identify the correlation of hypertension with persistent wound exudation and delayed wound healing in patients after femoral head replacement.
METHODS: Data of 205 elderly patients with femoral neck fractures were retrospectively analyzed. All patients underwent femoral head replacement. In accordance with the hypertension diagnostic criteria of 2010 Chinese Guidelines for the Management of Hypertension, patients were divided into hypertension group and control group. Intraoperative blood loss, postoperative blood loss, the days of prolonged wound exudation, the wound dehiscence, and the prevalence of delayed wound healing were compared between the two groups. Then, we analyzed the relationship of hypertension with wound exudation and delayed wound healing.
RESULTS AND CONCLUSION: (1) The average systolic blood pressures were 153.55 mmHg and 128.82 mmHg in the hypertension and control groups, respectively (P < 0.05). (2) No significant difference in age, gender, MNA-SF score, diabetes, body mass index, intraoperative blood loss, and postoperative blood loss was found between the two groups  (P > 0.05). (3) The time of persistent wound exudation was 4.03 days and 2.08 days in the hypertension group and control group, respectively (P < 0.05). (4) The prevalence of delayed wound healing was significantly higher in the hypertension group than that in the control group (P < 0.05). (5) Hypertensive patients had a higher risk of prolonged wound exudation and delayed healing than their normotensive counterparts, and the hypertension is one of the important influence factors for delayed wound healing. 

中国组织工程研究杂志出版内容重点:人工关节;骨植入物;脊柱骨折;内固定;数字化骨科;组织工程

Key words: Femoral Neck Fractures, Arthroplasty, Replacement , Hip, Wound Healing

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