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肩关节镜检查术后即刻出现的液体潴留和体重增加。

Immediate postoperative fluid retention and weight gain after shoulder arthroscopy.

作者信息

Lo Ian K Y, Burkhart Stephen S

机构信息

The San Antonio Orthopaedic Group, San Antonio, Texas, USA.

出版信息

Arthroscopy. 2005 May;21(5):605-10. doi: 10.1016/j.arthro.2005.01.008.

Abstract

PURPOSE

The primary purpose of this study was to determine the amount of weight gain immediately after shoulder arthroscopy. In addition, patient and surgical factors correlated with weight gain were analyzed. We hypothesized that there would be a significant increase in weight immediately after shoulder arthroscopy and that the amount of weight gain would correlate with a number of surgical factors.

TYPE OF STUDY

Observational case series.

METHODS

Fifty-three patients were enrolled in the study. There were 34 male and 19 female patients, with a mean age of 47.1 +/- 13.8 years. All patients were weighed before and after surgery using the same weight scale by the same observer. Weight gain was calculated and adjusted to account for the weight of the dressing and sling. Weight gain then was correlated to various clinical and surgical variables. Pearson correlation coefficients, Student t tests, and stepwise regression were used to determine significant correlations between clinical and surgical variables and weight gain.

RESULTS

The mean amount of net weight gain was 8.7 +/- 3.9 lb (range, 0.8-18.8 lb), representing 4.6% +/- 2.1% of preoperative weight. The mean amount of weight gain attributable to arthroscopy fluid only was 4.2 +/- 3.8 lb (range, 0-14.5 lb), representing a gain of 2.2% +/- 2.0% of preoperative weight. The mean amount of intravenous fluid infused was 1,885 +/- 547 mL, and the mean amount of normal saline arthroscopy fluid used was 30 +/- 24 L. Surgical time, the amount of arthroscopy fluid, the size of the rotator cuff tear, the number of tendons involved, the presence of a subscapularis tear, the number of procedures performed, the concomitant performance of a subacromial decompression, the number of BioCorkscrew (Arthrex, Inc., Naples, FL) anchors used, and the total number of anchors used all correlated with increasing weight gain (all P < .05). A procedure of stepwise regression selection did not identify any quantitative parameters attributable to weight gain other than the earlier-described parameters. There were no significant intraoperative or postoperative complications attributable to the amount of weight gain.

CONCLUSIONS

Weight gain immediately after shoulder arthroscopy is a common finding. Although no complications were seen in this group of patients, both patients and surgeons should be aware of this concern after shoulder arthroscopy and the potential complications related to it.

摘要

目的

本研究的主要目的是确定肩关节镜检查后立即出现的体重增加量。此外,还分析了与体重增加相关的患者因素和手术因素。我们假设肩关节镜检查后体重会显著增加,且体重增加量与一些手术因素相关。

研究类型

观察性病例系列。

方法

53例患者纳入本研究。其中男性34例,女性19例,平均年龄47.1±13.8岁。所有患者在手术前后均由同一名观察者使用同一台体重秤称重。计算体重增加量,并对敷料和吊带的重量进行校正。然后将体重增加量与各种临床和手术变量进行关联分析。采用Pearson相关系数、Student t检验和逐步回归分析来确定临床和手术变量与体重增加之间的显著相关性。

结果

净体重增加的平均量为8.7±3.9磅(范围为0.8 - 18.8磅),占术前体重的4.6%±2.1%。仅由关节镜检查液体导致的体重增加平均量为4.2±3.8磅(范围为0 - 14.5磅),占术前体重的2.2%±2.0%。静脉输注液体的平均量为1885±547毫升,关节镜检查使用的生理盐水平均量为30±24升。手术时间、关节镜检查液体量、肩袖撕裂大小、受累肌腱数量、肩胛下肌撕裂的存在情况、进行的手术数量、同时进行的肩峰下减压、使用的BioCorkscrew(Arthrex公司,佛罗里达州那不勒斯)锚钉数量以及使用的锚钉总数均与体重增加增加相关(所有P < 0.05)。逐步回归选择过程未识别出除上述参数外可归因于体重增加的任何定量参数。未发现因体重增加量导致的显著术中或术后并发症。

结论

肩关节镜检查后立即出现体重增加是常见现象。尽管该组患者未出现并发症,但患者和外科医生在肩关节镜检查后均应意识到这一问题及其潜在相关并发症。

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