屈膝位间断夹闭引流控制膝关节置换术后出血

发布时间：2019-02-12 18:13

【摘要】：[目的]探讨屈膝位间断夹闭引流在全膝关节置换术(total knee arthroplasty,TKA)后出血控制中的疗效。[方法]2012年7月~2015年11月,96例全膝关节置换术后患者纳入研究,随机分为两组,真空负压引流组(48例)术后行真空负压引流,间断夹闭引流管并维持患肢屈髋屈膝90°位,传统负压引流组(48例)行传统负压持续引流并维持髋膝关节伸直位。记录并比较两组患者术后24 h引流量、术后5 d血红蛋白丢失量、输血率、输血量、膝关节活动度、关节感染、伤口皮缘坏死、肢体肿胀及皮下淤斑情况。[结果]真空负压引流组在术后24 h引流量、术后5 d血红蛋白丢失量、输血量方面均显著低于传统负压引流组(P0.05),两组术后输血率、膝关节活动度、肢体肿胀及皮下淤斑差异均无统计学意义(P0.05),所有患者术后均无感染及伤口皮缘坏死发生。[结论]屈膝位间断夹闭引流对减少人工膝关节置换术后失血量及人均输血量有明显效果。
[Abstract]:[objective] to investigate the effect of intermittent clamping drainage in knee flexion position on bleeding control after total knee arthroplasty (total knee arthroplasty,TKA). [methods] from July 2012 to November 2015, 96 patients undergoing total knee arthroplasty were randomly divided into two groups: the vacuum negative pressure drainage group (48 cases) received vacuum negative pressure drainage after operation, the drainage tube was clipped intermittently and the knee flexion of the affected limb was maintained in 90 掳position. The traditional negative pressure drainage group (48 cases) underwent continuous negative pressure drainage and maintained the position of hip and knee joint elongation. The drainage flow 24 hours after operation, hemoglobin loss, blood transfusion rate, blood transfusion volume, knee motion, joint infection, wound skin edge necrosis, limb swelling and subcutaneous plaque were recorded and compared between the two groups. [results] the drainage rate, hemoglobin loss and blood transfusion volume in the vacuum negative pressure drainage group were significantly lower than those in the traditional negative pressure drainage group at 24 hours after operation (P0.05). The blood transfusion rate and knee joint activity were significantly lower in the vacuum negative pressure drainage group than in the traditional negative pressure drainage group (P0.05). There was no significant difference in limb swelling and subcutaneous plaque (P0.05). No infection or wound skin edge necrosis occurred in all patients after operation. [conclusion] intermittent clipping and drainage in flexion position can reduce blood loss and blood transfusion per person after knee arthroplasty.
【作者单位】：广东佛山市第一人民医院骨科;南方医科大学第三附属医院骨科;
【分类号】：R687.4

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