全髋置换术后引流管两种处理方式的比较

The Comparison of Two Different Managements of Drainage after Total Hip Arthroplasty

目的探讨全髋关节置换术后两种不同方式处理引流管的临床意义。方法自2009年10月至2011年5月,共选择50例全髋置换患者,对其中20例术后引流管采用间断夹闭的方式(间断夹闭组),另30例术后引流管采用持续引流作为对比(持续引流组)。分别比较患者术后24 h血红蛋白浓度(hemoglobin,Hb)及红细胞压积(hematocrit,Hct)、术后24 h及48 h引流量、术后疼痛程度、切口愈合情况、术后2年髋关节功能评分(Harris评分)。结果两组患者术后24h血红蛋白浓度、红细胞压积以及术后24h引流量、48h引流量相比较差异有统计学意义(P<0.05),术后第2天、第7天疼痛程度以及术后2年髋关节Harris评分相比较差异无统计学意义(P>0.05)。结论全髋关节置换术后间断夹闭引流管能够有效减少术后引流量及控制关节腔内渗血,但在临床应用过程中需要注意引流量的变化及病例的选择。

Abstract：Objective To discuss the clinic value of two different managements to the drain after total hip arthroplasty. Methods From October 2009 to May 2011, a total of 50 cases that had total hip arthroplasty were enrolled. Among them,20 cases experienced intermittent clamping of the drainage tube （intermittent clamping group） ,30 cases had in continuous drain- age tube （ continuous drainage group）. We compared the levels of hemoglobin and hematocrit at 24 h after operation,the blood drainage at 24 h and 48 h after operation, pain degree,wound healing and Harris hip score at 1 year after operation. Results The difference of two groups was significant in the levels of hemoglobin and hematocrit at 24 h after operation and the blood drainage at 24 h and 48 h after operation （ P 〈 0.05 ）. However, there was no difference in pain degree at 2 and 7 day after op- eration and Harris hip score at 2 year after operation （P 〉 0.05）. Conclusion Intermittent clamping of the drainage tube can effectively reduce the blood drainage and control the intra-artieular penetration after operation, but we should pay attention to the change of blood drainage and the choice of operative case.