初次人工膝关节置换术后患者伤口引流血量观察与护理

Observation and Care of Wound Drainage after Primary Total Knee Arthroplasty

目的探讨人工膝关节置换术后时间与引流血量的关系,比较术后不同引流方式对引流血量及异体血输入情况的影响。方法观察120例人工膝关节置换术后患者8 h内引流血量情况,分析其变化趋势;观察术后不同引流方式的引流血量及异体血输入情况。结果人工膝关节置换术后8 h内的引流血量占总引流量的90%以上,其中术后最初4 h为出血高峰期。应用普通引流袋和自体血回输装置术后引流血量比较,差异无统计学意义,两种方法术后异体血输入情况比较,差异有统计学意义。结论在对初次人工膝关节置换术后伤口引流的护理中,需加强术后8 h内尤其是术后最初4 h的监护,防止血压急剧下降甚至失血性休克的发生。同时应用自体血回输装置进行伤口引流可有效补充自体血,减少异体血输注,防止相关并发症。

Objective To explore the relation between time and wound drainage volume after total knee arthroplasty and compare the effects of different drainage methods on drainage volume so as to provide instruction for clinical care. Methods The drainage volume in 120 patients was observed 8 hours after total knee arthroplasty. The drainage volume by different drainage means was observed and compared statistically. Results The drainage volume within 8 hours after knee arthroplasty took up 90% of the total volume, with the peak around 4 hours. Drainage bag and autoblood retransfusion device showed insignificance in drainage volume, statistically. Conclusion In caring the patients after primary total knee arthroplasty, the monitoring should be enhanced in 8 hours, especially in the first 4 hours, to prevent drop of blood pressure and hemorrhagic shock. Meanwhile, autoblood retransfusion device can be used for wound drainage, effectively compensating autoblood and reducing transfusion of allo-blood so as to prevent relevant complications.