是否止血带下KD-Ⅲ-M膝关节脱位的修复重建

Reconstruction and repair of ligaments for KD-Ⅲ-M knee dislocation with or without tourniquet

摘要:

[目的] 比较止血带及无止血带下行关节镜下多韧带重建治疗KD-Ⅲ-M 型膝关节脱位的临床疗效。[方法] 选取2017 年1 月~2022 年1 月收治的27 例膝关节脱位合并多韧带损伤的患者，采用随机数字表法分为两组。止血带组13 例全程于止血带下行手术；无止血带组14 例，全程于无止血带下手术。比较两组围手术期资料及随访结果。[结果] 两组患者均顺利完成手术，两组手术时间、术中失血量、术后首次下床时间、术后住院天数的差异均无统计学意义（P＞0.05），无止血带组的术后引流量显著少于止血带组[(35.6±2.7) ml vs (72.2±3.3) ml, P＜0.001]。术后随时间推移，两组VAS 评分显著减少（P＜0.05），Lysholm 和IKDC 评分显著增加（P＜0.05）。术后1 周，无止血带组的VAS 评分显著少于止血带组[(4.4±0.8) vs (5.6±0.9), P=0.021]，其他相应时间点，两组VAS 评分的差异均无统计学意义（P＞0.05）。相应时间点，两组Lysholm 和IKDC 评分的差异均无统计学意义（P＞0.05）。[结论] 关节镜下多韧带重建治疗KD-Ⅲ-M 型膝关节脱位疗效满意，而无非止血带下行该手术具有引流少及早期疼痛较轻等优势。

Abstract:

[Objective] To compare the clinical effect of multi-ligament reconstruction and repair with or without tourniquet for KD-Ⅲ-M knee dislocation. [Methods] A total of 27 patients with knee joint dislocation combined with multiple-ligament injuries admittedfrom January 2017 to January 2022 were randomly divided into two groups using a random number table. In the tourniquet group, 13 pa-tients received multi-ligament reconstruction and repair underwent tourniquet, while in the non-tourniquet group, 14 cases were operatedon without tourniquet. The perioperative data and follow-up results were compared between the two groups. [Results] All patients in bothgroups were operated successfully without significant differences in terms of operation time, intraoperative blood loss, ambulation time aftersurgery, postoperative hospitalization days between the two groups (P＜0.05). However, the non-tourniquet group had significantly lowerpostoperative drainage volume than the tourniquet group [(35.6±2.7) ml vs (72.2±3.3) ml, P＜0001]. The VAS scores significantly decrease,whereas the Lysholm and IKDC scores significantly increased in both groups over time postoperatively (P＜0.05). The non-tourniquet groupproved significantly superior to the tourniquet group in VAS score 1week after surgery [(4.4±0.8) vs (5.6±0.9), P=0.021], despite of the factthat it became not significant between the two groups latterly (P＞0.05). There were no statistically significant differences in Lysholm and IK-DC scores between the two groups at any corresponding time points (P＞0.05). [Conclusion] The multi-ligament reconstruction and repairfor KD-Ⅲ-M dislocation of the knee achieve satisfactory clinical consequences, while the non-tourniquet operation has the advantages ofless drainage and less early pain.