【摘要】：[目的]探討屈膝位間斷夾閉引流在全膝關(guān)節(jié)置換術(shù)(total knee arthroplasty,TKA)后出血控制中的療效。[方法]2012年7月~2015年11月,96例全膝關(guān)節(jié)置換術(shù)后患者納入研究,隨機分為兩組,真空負壓引流組(48例)術(shù)后行真空負壓引流,間斷夾閉引流管并維持患肢屈髖屈膝90°位,傳統(tǒng)負壓引流組(48例)行傳統(tǒng)負壓持續(xù)引流并維持髖膝關(guān)節(jié)伸直位。記錄并比較兩組患者術(shù)后24 h引流量、術(shù)后5 d血紅蛋白丟失量、輸血率、輸血量、膝關(guān)節(jié)活動度、關(guān)節(jié)感染、傷口皮緣壞死、肢體腫脹及皮下淤斑情況。[結(jié)果]真空負壓引流組在術(shù)后24 h引流量、術(shù)后5 d血紅蛋白丟失量、輸血量方面均顯著低于傳統(tǒng)負壓引流組(P0.05),兩組術(shù)后輸血率、膝關(guān)節(jié)活動度、肢體腫脹及皮下淤斑差異均無統(tǒng)計學(xué)意義(P0.05),所有患者術(shù)后均無感染及傷口皮緣壞死發(fā)生。[結(jié)論]屈膝位間斷夾閉引流對減少人工膝關(guān)節(jié)置換術(shù)后失血量及人均輸血量有明顯效果。
[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 擄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.
【作者單位】： 廣東佛山市第一人民醫(yī)院骨科;南方醫(yī)科大學(xué)第三附屬醫(yī)院骨科;
【分類號】：R687.4

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