全髋关节置换术切口不引流的临床应用及效果观察

Clinical application and effect of incision total hip replacement without drainage

目的比较全髋关节置换术后切口放置引流管与不放置引流管对患者康复疗效的影响。方法选取我院收治的股骨头无菌性坏死及单侧新鲜股骨颈骨折患者102例,按入院时间分为术后不引流A组50例和术后引流B组52例。两组均为初次行单侧全髋关节置换术,对两组患者的护理情况进行回顾性分析。结果两组术后退热时间、输血人数、术后下地时间比较,差异无统计学意义(P=0.062;P=0.541;P=0.143);A组出现术后并发症3例,B组出现术后并发症7例;两组术后髋关节功能Harris评分、护理工作量比较有明显差异(P=0.021;P=0.035);两组总的并发症发生率差异有统计学意义(χ2=1.460,P=0.027)。结论与传统切口引流相比,初次全髋关节置换术后不放置引流管可减少术后卧床并发症的发生,减少护理工作量,加速髋关节功能活动的恢复,值得临床推广。

Objective To compare the effect of rehabilitation after total hip replacement between patients with incision drainage tube placement and patients without drainage tube placement. Methods A total of 102 patients with aseptic necrosis of femoral head or fresh femoral neck fracture were selected in the research. According to admission time, they were divided into two groups, 50 cases with incision drainage tube placement as group A and 52 cases with no postoperative drainage as group B. All patients in two groups received unilateral total hip replacement for the first time, nursing in two groups were analyzed retrospectively. Results There was no statistically significant difference in regression time of fever after surgery, the number of blood transfusion, first mobile time after surgery（P=0.062, P=0.541, P=0.143）.3 cases of postoperative complications happened in group A, while 7 cases in group B. There was obvious difference in postoperative hip function Harris score, nursing workload between two groups（P=0.021, P=0.035）. The incidence of complications between the two groups was statistically significant（χ^2=1.460, P=0.027）. Conclusion Compared with the traditional incision drainage, no drainage tube placement after primary total hip replacement may reduce postoperative complications of the bed, reduce nursing workload, and may help hip function recovery. It is worth promoting clinically.