微孔多聚糖止血球在全膝关节置换术中的应用评价

Effectiveness of microporous polysaccharide hemispheres in total knee arthroplasty

目的探讨微孔多聚糖止血球(microporous polysaccharide hemospheres,MPH)在全膝关节置换术(total knee arthroplasty,TKA)中的应用价值。方法2008年1月至2009年4月行初次TKA的患者80例,其中40例术中使用微孔多聚糖止血球,作为MPH组;另40例术中未使用微孔多聚糖止血球,作为对照组。以手术时间、围手术期失血量、输血人数和术后切口感染发生数为评价指标,对两组进行比较。结果MPH组和对照组的手术时间分别(72.6±5.5)min和(75.0±4.6)min,差异无统计学意义(P=0.35);术中出血量分别为(373.6±53.2)ml和(377.4±55.1)ml,差异无统计学意义(P=0.87);输血人数两组间无统计学差异(P=0.59)。MPH组和对照组的术后可见失血量分别为(189.7±22.0)ml和(264.6±45.5)ml,差异有统计学意义(P=0.01);手术总出血量分别为(563.4±56.0)ml和(642.0±75.0)ml,差异有统计学意义(P=0.04)。两组均未出现切口感染。结论微孔多聚糖止血球可以有效降低TKA的总失血量,降低切口感染的发生。

Objective To explore the effect of microporous polysaccharide hemispheres （MPH） as a novel hemostatic agent in total knee artbroplasty （TKA）. Methods From January 2008 to April 2009, 80 patients who underwent primary TKA were enrolled in this study. 40 patients were divided in MPH group which MPH was used during the operation; the other 40 patients were taken as the control group without the use of MPH. The operative time, perioperative blood loss, number of transfusion and number of surgical - site infection was evaluated. Results Compared with control group, the MPH group showed significant decrease on postoperative blood loss （189.7 ±22. 0ml vs 264. 6 ±45.5ml, P = 0. 01 ） and total perioperative blood loss （563.4 ±56. 0ml vs 642. 0± 75.0ml, P = 0. 04）. There was no significant difference on operative time （ 72. 6±5.5min vs 75.0 ± 4. 6rain, P = 0. 35 ）, intraoperative blood loss （ 373.6 ±53.2ml vs 377.4 ± 55. lrnl, P = 0. 87） and number of transfusion （P = 0. 59）. No surgical - site infection was found in either group. Conclusion MPH is effective to reduce total perioperative blood loss in TKA, and does not increase the risk of surgical - site infection. Therefore, it can be recommended for clinical application.