本文選題：股骨頸骨折 + 全髖關(guān)節(jié)置換�。� 參考：《中國矯形外科雜志》2017年10期

【摘要】：[目的]探討高血壓對全髖關(guān)節(jié)置換術(shù)后傷口持續(xù)滲出和延遲愈合的影響。[方法]回顧性分析2013年1月~2016年4月間解放軍第81醫(yī)院骨科收治的167例老年股骨頸骨折患者資料,男91例,女76例,年齡65~90歲,平均74.56歲。所有患者均接受全髖關(guān)節(jié)置換術(shù)治療;根據(jù)《中國高血壓防治指南2010》中的高血壓診斷標(biāo)準(zhǔn)分為高血壓組和非高血壓組,主要比較兩組術(shù)中失血量、術(shù)后失血量、拆線時(shí)間、傷口持續(xù)滲出時(shí)間、傷口裂開和傷口延遲愈合發(fā)生率是否有差異,分析高血壓與傷口延遲愈合的關(guān)系。兩組間數(shù)據(jù)的比較采用獨(dú)立樣本t檢驗(yàn)。[結(jié)果]高血壓組患者平均收縮壓為151.86 mmHg(1 mmHg=0.133 kPa),非高血壓組為122.93 mmHg,差異有統(tǒng)計(jì)學(xué)意義(P0.05);兩組患者平均年齡、性別、體質(zhì)量指數(shù)(BMI)、術(shù)前合并糖尿病情況、致傷機(jī)制、術(shù)前住院時(shí)間、術(shù)中及術(shù)后失血量差異均無統(tǒng)計(jì)學(xué)意義(P0.05);高血壓患者傷口持續(xù)滲出時(shí)間為3.82 d,非高血壓患者為1.95 d,差異有統(tǒng)計(jì)學(xué)意義(P0.01);高血壓組傷口拆線時(shí)間為15.35 d,明顯高于非高血壓組的13.42 d(P0.01);高血壓組切口延遲愈合發(fā)生率明顯高于非高血壓組(31.43%VS 14.52%),差異有統(tǒng)計(jì)學(xué)意義(P0.01)。5例高血壓患者發(fā)生傷口裂開,非高血壓患者未發(fā)生傷口裂開,因例數(shù)太少,未進(jìn)行統(tǒng)計(jì)學(xué)分析。[結(jié)論]高血壓患者全髖關(guān)節(jié)置換術(shù)后傷口持續(xù)滲出和傷口延遲愈合發(fā)生率的風(fēng)險(xiǎn)明顯增高,高血壓是切口延遲愈合的重要影響因素之一。
[Abstract]:[Objective] to investigate the effect of total hip arthroplasty] postoperative wound sustained exudation and delayed healing of hypertension. Methods a retrospective analysis of 167 cases of senile femoral neck in January 2013 ~2016 year in April admitted to the Department of orthopedics, eighty-first Hospital of PLA fracture patients, male 91 cases, female 76 cases, age 65~90 years old, average 74.56 years old. All patients received total hip arthroplasty; according to the diagnostic criteria of hypertension guidelines for prevention and treatment of hypertension China in 2010> were divided into hypertension group and non hypertension group, mainly compared two groups of intraoperative blood loss, postoperative blood loss, clearing time, persistent wound leakage time, wound dehiscence and delayed wound healing occurred if there are differences in analysis the relationship between hypertension and delayed wound healing. Compared with the data between the two groups of independent sample t test. Results in hypertensive patients, the mean systolic blood pressure was 151.86 mmHg (1 mmHg=0.133 kPa) and non hypertension group. For 122.93 mmHg, the difference was statistically significant (P0.05); the average age of the two groups of patients, gender, body mass index (BMI), diabetes mellitus before operation, mechanism of injury, hospitalization time of preoperative, intraoperative and postoperative blood loss showed no significant difference (P0.05); high blood pressure in patients with persistent wound from time 3.82 D, non hypertensive patients was 1.95 D, the difference was statistically significant (P0.01); hypertension group suture removal time was 15.35 D, significantly higher than non hypertension group 13.42 D (P0.01); hypertension group the incidence of delayed wound healing rate was significantly higher in non hypertension group (31.43%VS 14.52%), the difference was statistically significant (P0.01).5 cases of hypertensive patients with non hypertensive patients without wound dehiscence, wound dehiscence occurred, because the number of cases is too small, not for statistical analysis. Conclusion: hypertension patients after total hip replacement wound sustained exudates and delayed wound healing rate The risk was significantly higher, and hypertension was one of the most important factors for the delayed healing of the incision.

【作者單位】： 南京中醫(yī)藥大學(xué)附屬81醫(yī)院骨科;
【基金】：南京市科技計(jì)劃項(xiàng)目(編號(hào):201503007) 南京軍區(qū)科技創(chuàng)新項(xiàng)目(編號(hào):15ZD020)
【分類號(hào)】：R544.1;R687.4
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本文編號(hào)：1744795