止血带在全膝关节置换术中不同应用方式的比较研究

发布时间：2018-03-19 10:50

本文选题：全膝关节置换术　切入点：止血带　出处：《中国现代医学杂志》2017年16期 　论文类型：期刊论文

【摘要】：目的分析对比止血带应用于不同时期全膝关节置换术(TKA)的疗效差异。方法随机选取于2015年6月-2016年12月于该院接受全膝关节置换术治疗的患者共计78例,根据术中应用止血带方式的不同将患者随机分为3组:A组(术中接受全程止血带治疗),B组(仅于假体安装时应用止血带治疗,于膝关节假体成功放置且骨水泥硬化时结束,即限制性使用止血带),C组(于截骨后开始应用止血带,加压包扎后停止使用),每组各26例。比较3组患者止血效果以及术后膝关节功能恢复情况,评估TKA术中不同时期给予止血带治疗的效果差异。结果 3组患者手术时间、围手术期失血量及输血例数比较,差异无统计学意义(P0.05),与A、C组比较,B组隐性失血较少,术后并发症发病率低,住院时间减少,膝关节功能恢复相关评分以及软组织损伤指标改善显著(P0.05)。结论限制性使用止血带能够有助于降低患者隐形出血量,同时减少患者肢体肿胀,有助于患者术后膝关节功能恢复并减少术后并发症的发生,为全膝关节置换术后患者膝关节早期功能恢复提供有力支持,值得临床推广应用。
[Abstract]:Objective to compare the therapeutic effects of tourniquet on total knee arthroplasty in different periods. Methods 78 patients who received total knee arthroplasty from June 2015 to December 2016 were randomly selected. The patients were randomly divided into 3 groups according to the pattern of tourniquet applied during the operation. Group A received the whole tourniquet therapy during the operation. Group B was treated with tourniquet only when the prosthesis was installed and ended when the knee joint prosthesis was successfully placed and the bone cement was sclerosis. There were 26 cases in each group (26 cases in each group). The hemostatic effect and the recovery of knee joint function were compared among the 3 groups. Results there was no significant difference in the time of operation, the amount of blood loss in perioperative period and the number of blood transfusions in the three groups. There was no significant difference between the three groups (P 0.05), but the hidden bleeding in group B was less than that in group A (C). The incidence of postoperative complications was low, the length of hospitalization was reduced, the scores of knee joint function recovery and soft tissue injury were improved significantly (P0.050.Conclusion restrictive use of tourniquet can help to reduce the amount of invisible bleeding in patients. At the same time, it can reduce the swelling of limbs, which is helpful to the recovery of knee joint function and reduce the occurrence of postoperative complications. It is worth popularizing and applying in clinical practice because it can support the early functional recovery of knee joint after total knee arthroplasty.
【作者单位】：安徽医科大学附属省立医院骨科;
【分类号】：R687.4

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