| 早期间断夹闭引流管对全膝关节置换术后出血量影响的病例对照研究 |
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Received:August 19, 2018
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| 作者 | Author | 单位 | Unit | E-Mail |
| 袁义 |
YUAN Yi |
宁波市第二医院骨科中心关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.2 Hospital, Ningbo 315000, Zhejiang, China |
nbjoint@163.com |
| 章海均 |
ZHANG Hai-jun |
宁波市第二医院骨科中心关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.2 Hospital, Ningbo 315000, Zhejiang, China |
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| 张波 |
ZHANG Bo |
宁波市第二医院骨科中心关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.2 Hospital, Ningbo 315000, Zhejiang, China |
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| 杨超 |
YANG Chao |
宁波市第二医院骨科中心关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.2 Hospital, Ningbo 315000, Zhejiang, China |
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| 罗浩 |
LUO Hao |
宁波市第二医院骨科中心关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.2 Hospital, Ningbo 315000, Zhejiang, China |
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| 陈阳 |
CHEN Yang |
宁波市第二医院骨科中心关节外科, 浙江 宁波 315000 |
Department of Joint Surgery, Ningbo No.2 Hospital, Ningbo 315000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2019年32卷，第1期，第60-63页 |
| DOI：10.3969/j.issn.1003-0034.2019.01.013 |
| 基金项目:宁波市科技惠民项目（编号：2016C51003） |
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目的：探讨早期间断夹闭引流管对全膝关节置换术后出血量的影响。
方法：选取2014年1月至2015年1月行全膝关节置换术（total knee arthroplasty，TKA）治疗的膝骨关节炎患者60例，根据术后不同的引流方式分为试验组和对照组。试验组30例，男12例，女18例；年龄58~76（67.0±6.7）岁，术前血红蛋白（128.82±8.29）g/L；每2 h开放引流管10 min，直至6 h后一直开放引流管。对照组30例，男13例，女17例；年龄60~79（69.0±7.2）岁；术前血红蛋白（126.55±8.49）g/L；6 h内持续负压引流。观察并记录两组患者术中失血量、术后引流量、总失血量、隐性失血量及异体血输血及住院期间局部伤口情况。
结果：试验组术后引流量及总失血量分别为（184±56）ml、（1 014±258）ml，对照组为（476±98）ml、（1 390±383）ml，试验组少于对照组（P<0.05）；两组术中出血量及隐性失血量比较差异无统计学意义（P>0.05）。两组伤口甲级愈合，术后无感染病例，试验组肢体肿胀和瘀斑数量分别为（3.8±0.9）cm和10例，对照组肢体肿胀和瘀斑数量分别为（3.4±0.7）cm和8例，两组比较差异无统计学意义（P>0.05）。试验组5例患者进行了输血，对照组13例患者进行了输血，两组比较差异有统计学意义（P<0.05）。
结论：采用TKA术后6 h内间断夹闭切口引流管的方法可减少引流量、总的出血量及输血率，且并不加重肢体肿胀程度及皮下瘀斑，是TKA术后减少出血的有效措施之一。 |
| [关键词]:关节成形术,置换,膝 骨关节炎,膝 引流术 病例对照研究 |
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| Case-control study on effect of early intermittently closing drainage tube for blood loss after total knee arthroplasty |
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Abstract:
Objective: To explore effect of early intermittently closing drainage tube on blood loss control after total knee arthroplasty.
Methods: Totally 60 total knee replacement patients were randomly divided into experimental group and control group according to the different drainage ways of postoperative from January 2014 to January 2015. There were 30 patients in experimental group,including 12 males and 18 females,aged from 58 to 76 years old with an average of (67.0±6.7) years old,preoperative Hb was(128.82±8.29) g/L; drainage tubes were intermittently opened for 10 minutes every 2 hours,and kept opened until 6 h after operation. There were 30 patients in control group,including 13 males and 17 females;aged from 60 to 79 years old with an average of(69.0±7.2) years old;Preoperative Hb was(126.55±8.49) g/L; tubes were kept open with negative pressure before its removing. Blood loss in operation,postoperative drainage,total blood loss,hidden blood loss,allogenic blood transfusion and local wounds during hospitalization were observed and compared.
Results: Postoperative drainage and total blood loss in experimental group was(184±56) ml,(1 014±258) ml;and significantly lower than that of control group(476±98) ml,(1 390±383) ml(P<0.05);there were no statistical differences in interoperation blood loss and hidden blood loss(P>0.05). The incisions between two groups were healed at stage Ⅰ without infection. The size of limb swelling and the number of the cases with ecchymosis in experimental group was (3.8±0.9) cm and 10 respectively; control group was (3.4±0.7) cm and 8,while there were no significant differences between two groups(P>0.05). Five patients in experimental group were performed blood transfusion,13 patients in control group were performed blood transfusion,and with differences between two groups(P<0.05).
Conclusion: Intermittently closing of drainage tube after 6 h of TKA could reduce the amount of drainage,total blood loss and blood transfusion rate,and not aggravate limb swelling and subcutaneous ecchymosed. It is proved to be an effective measure to reduce bleeding after TKA. |
| KEYWORDS:Arthroplasty,replacement knee Osteoarthritis,knee Drainage Case-control study |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 袁义,章海均,张波,杨超,罗浩,陈阳.早期间断夹闭引流管对全膝关节置换术后出血量影响的病例对照研究[J].中国骨伤,2019,32(1):60~63 |
| 英文格式: | YUAN Yi,ZHANG Hai-jun,ZHANG Bo,YANG Chao,LUO Hao,CHEN Yang.Case-control study on effect of early intermittently closing drainage tube for blood loss after total knee arthroplasty[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(1):60~63 |
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