本文選題：骨性關節(jié)病 + 全膝關節(jié)置換術��； 參考：《青海大學》2017年碩士論文

【摘要】：目的:探討本地區(qū)膝關節(jié)置換術后切口周圍溫度變化趨勢及規(guī)律;并了解皮溫變化與相關實驗室炎性指標的關系。方法:測量膝關節(jié)置換(TKA)患者術前1天,術后第1天、第3天、第5天、第7天、第14天、第4周、第12周、第24周、第48周患者體溫、雙側膝關節(jié)皮膚溫度。并同時監(jiān)測患者術前1天,術后第1天、第3天、第5天、第7天、第4周、第12周、第24周的C反應蛋白(CRP)、紅細胞沉降率(ESR)、白細胞介素-6(IL-6),降鈣素原(PCT)。結果:術前雙側膝關節(jié)皮溫相比無統(tǒng)計學差異(P0.05);術后術側及健側第1、3、5、7、14天、4周、12周、24周相比有統(tǒng)計學差異(P0.05)。本研究表明TKA術后雙側膝關節(jié)皮膚溫度均較術前升高,術側溫度升高大于非手術側,術后3-7天雙側皮膚溫差較大,雙膝關節(jié)皮溫差在術后隨時間推移逐漸縮小,皮溫差在術后24周以后基本沒有差別,術后48周雙側皮溫無差異。CRP、ESR、IL-6、PCT在術后升高,雖然峰值出現(xiàn)的時間先后不同,但術后3-7天以上炎性指標血漿濃度升高明顯,術后隨時間推移基本降至正常水平的時間不同。結論:切口周圍皮膚溫度的升高多考慮是TKA術后手術創(chuàng)傷引起的,隨著術后炎性反應逐漸消退切口皮膚溫度逐漸和對側相同。術后CRP、ESR、IL-6、PCT變化的趨勢與皮膚溫度變化的趨勢基本一致。而對于本地區(qū)病例而言高于本研究的TKA術后皮溫變化水平,要引起臨床醫(yī)生的重視,警惕感染的發(fā)生。
[Abstract]:Objective: to investigate the trend and regularity of the changes in the peripheral temperature of the incision after knee arthroplasty, and to understand the relationship between the changes of the skin temperature and the laboratory inflammatory indexes. Methods: the body temperature and skin temperature of bilateral knee joint were measured 1 day before operation, 1 day, 3 days, 5 days, 7 days, 14 days, 4 weeks, 12 weeks, 24 weeks and 48 weeks of knee arthroplasty. At the same time, the C-reactive protein (CRP), erythrocyte sedimentation rate (RSR), interleukin-6 (IL-6) IL-6 and procalcitonin (PCT) were monitored 1 day before operation, 1 day, 3 days, 5 days, 7 days, 4 weeks, 12 weeks and 24 weeks after operation. Results: there was no significant difference in the skin temperature of bilateral knee joint before operation (P 0.05), and there was a significant difference between the operation side and the normal side (P 0.05). This study showed that the skin temperature of the bilateral knee joint after TKA was higher than that of the preoperative, and the skin temperature difference of the bilateral knee joint was larger than that of the non-operative side. The skin temperature difference of the knee joint decreased gradually with time after operation. There was no difference in skin temperature after 24 weeks postoperatively, but there was no difference in skin temperature between the two sides at 48 weeks after operation. Although the peak value appeared at different time, the plasma concentration of inflammatory markers above 3-7 days after operation was obviously increased. After the operation, the time of basically falling to the normal level was different with the passage of time. Conclusion: the increase of skin temperature around the incision is mainly caused by the wound after TKA, and the skin temperature of the incision gradually decreases with the inflammatory reaction after the operation and is the same as that of the contralateral side. After operation, the trend of PCT change was consistent with that of skin temperature. However, the change level of skin temperature in this area is higher than that in this study, so clinicians should pay attention to it and be alert to the occurrence of infection.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R687.4

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