夜间进行人工全膝关节置换对预后的影响

文题释义：人工膝关节置换：是指利用金属、高分子聚乙烯等材料，根据人体膝关节形态、受力及功能制成人工关节假体，通过外科技术将假体植入人体内。人工膝关节置换是治疗重度膝关节骨关节炎的最佳手段，能够有效减轻患者肢体疼痛，改善关节活动度及功能，提高患者生活质量。 夜间手术：大部分膝关节置换患者是在三级医院接受手术治疗的，但由于膝关节置换患者的快速增多，以及医院的手术房间、外科医生、麻醉医师数量的限制，部分患者会在夜间(18：01-7：59)接受常规人工膝关节置换手术治疗。 背景：对于夜间行手术治疗是否会影响患者安全及预后一直存在争议。 目的：对比白天与夜间手术行全膝关节置换的安全性与预后差异。 方法：回顾性分析2015年1月至2018年1月在滨州医学院附属医院接受单侧全膝关节置换712例患者的资料，其中615例在白天(8：00-18：00)接受全膝关节置换治疗，97例在夜间(18：01-7：59)接受全膝关节置换治疗。比较两组的围术期及预后情况。试验获得滨州医学院附属医院伦理委员会批准，批准号：LW2016013。 结果与结论：①围术期：夜间手术组手术时间短于白天手术组(P < 0.05)，术中出血量与术后24 h引流量多于白天手术组(P < 0.05)；两组术后输血率、术后深静脉血栓发生率、术后感染率、术后假体周围感染率、术后发热率、术后住院时间比较差异均无显著性意义(P > 0.05)；②预后：两组术后7 d、1个月、3个月、1年的膝关节活动度与膝关节功能KSS评分比较差异均无显著性意义(P > 0.05)；③结果表明：夜间手术未增加全膝关节置换后的不良反应发生率，不影响患者的预后。 ORCID: 0000-0001-9160-451X(杜长岭) 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

Effect of nighttime total knee arthroplasty on prognosis

BACKGROUND:Whether nighttime surgery will affect the safety and prognosis of patients has been controversial.OBJECTIVE:To compare the safety and prognosis of daytime surgery versus nighttime surgery in patients receiving total knee arthroplasty.METHODS:Data of 712 patients who received unilateral total knee arthroplasty from January 2015 to January 2018 in the Binzhou Medical University Hospital were retrospectively analyzed.Of the patients,615 cases were treated by total knee arthroplasty during daytime hours(8:00-18:00)and the other 97 patients were treated by total knee arthroplasty during nighttime hours(18:01-7:59).The perioperative and postoperative conditions of the two groups of patients were compared.This study was approved by the Medical Ethics Committee of Binzhou Medical University Hospital,China(approval No.LW2016013).RESULTS AND CONCLUSION:(1)Perioperative period:The operation time in the nighttime surgery group was shorter than that in the daytime surgery group(P<0.05).The amount of intraoperative bleeding and 24 hours postoperative drainage were more in the nighttime surgery group than that in the daytime surgery group(P<0.05)There was no statistically significant difference in blood transfusion rate,the incidence of deep vein thrombosis,postoperative infection rate,postoperative periprosthetic infection rate,postoperative fever rate,and length of hospital stay between the two groups(P>0.05).(2)Prognosis:There was no significant difference in motion range and knee joint function KSS score between the two groups(P>0.05).(3)The results showed that nighttime surgery did not increase the incidence of adverse reactions after total knee arthroplasty,and did not affect the prognosis of patients.