全膝关节置换术后引流管的拔管时机对隐性失血的影响

The Influence of Drainage Pipe Tube Drawing Timing on the Hidden Blood Loss after Total Knee Arthroplasty

目的探讨全膝关节置换术(total knee arthroplasty,TKA)术后不同拔管时间对隐性失血(hidden blood loss,HBL)的影响。方法选取2011年9月～2012年9月间于本院完成的初次TKA患者90例,根据拔管时间不同分为24、48和72h拔管组,记录患者体重、身高、术前红细胞压积(hematocrit,Hct),计算所有患者的总失血量、术中出血量、术后引流量,推算出隐性失血量。结果随着引流管留置时间的延长,实际总失血量、显性失血量和术后引流量均逐渐增加,其中实际总失血量三组间差异无统计学意义(P>0.05);引流量、显性失血量和隐性失血量三组间差异有统计学意义(P<0.05或0.01),三组术中出血量差异无统计学意义(P>0.05);72h组引流量明显多于24h组(P<0.01),而隐性失血量24h组和48h组间差异无统计学意义,72h组明显少于24h组和48h组(P<0.01),72h隐性失血只占实际总失血量的20%。结论延长引流管留置时间可显著减少TKA术后隐性失血量,有助于减轻术后肢体肿胀及促进关节功能恢复。

Objective To investigate the influence of different tube drawing time on the recessive blood loss after total knee arthroplasty( TKA). Methods 90 cases with primary TKA were divided into 24 hours tube drawing group,forty-eight hours tube drawing group and 72 hours tube drawing group according to the tube drawing time. The patients’ weight,height,preoperative Hct were recorded. All of the patients of total blood loss,intraoperative blood loss,postoperative flow,calculation recessive blood loss were calculated. Results Total blood loss among three groups showed no statistically significant( P &gt; 0. 05). Drainage volume,obvious blood loss and hidden blood loss among three groups showed significant difference( P &lt; 0. 05). Drainage of 24 hour group were significantly less that that of 72 hour group( P &lt; 0. 01). Conclusion Prolong drainage tube indwelling time can significantly reduce the number of hidden blood loss after TKA. It is helpful to reduce postoperative limb swelling and promote joint functional recovery.