全膝关节置换术后切口引流的临床观察

Clinical observation of incision drainage after total knee replacement

目的分析人工全膝关节置换术(TKR)后常规引流液及伤口愈合情况,探讨早期2h内夹闭引流管的临床意义。方法行TKR手术患者40例,术后留置引流管,密切观察创口引流情况。2h引流量≤300ml时夹闭引流管并密切观察患者患侧肢体切口渗出、膝关节肿胀及远端感觉、运动、血液循环情况,并监控患者生命体征。结果引流管及时夹闭患者36例,引流管口及切口有少量渗血28例,夹闭后经观察未见膝关节明显肿胀,肢体远端感觉、运动及血液循环正常,引流过程中,患者生命体征均未出现明显变化。患者出院时膝关节未见明显肿胀,肢体远端血液循环正常。在助力器保护下,患者均能下床行正常功能锻炼。结论及时早期夹闭引流管不但能有效减少术后引流量,还能减少过快、过多引流对患者造成的心理影响,有利于早期进行功能锻炼。

Objective To analyse the conventional drainage fluid and wound healing situation after total knee replace- ment（TKR） ,and to discuss the clinical value of closing drainage in early 2h. Methods 40 cases patients of TKR,indweUed drainage pipe after operation, observed the incision drainage situation closely. When the drainage amount in 2h ≤300ml, occlu- ded the drainage pipe, observed the incision bleeding, articular swelling and sensation, motion, circulation situation of distal limbs,and monitored vital signals of patients. Results 36 cases patients closed drainage pipe in time,28 cases had a few ooze blood in the drainage pipe orifice and incision,after drainage pipe occluded,there was no obvious knee joint swelling,the sen- sation,motion,circulation situation of distal limbs was normal,there was no obvious change in vital signals of patients through drainage process. When discharged, there was no obvious knee joint swelling, and circulation situation of distal limbs was nor- mal, under the protection of booster, patients could leave bed and do some function exercise. Conclusion Occluding the drain- age pipe early and in time can not only effectively reduce the drainage volume,but also can relieve psycological impact resulted in drainage too much and too fast, and is benefite to early function exercise.