早期夹闭引流管对膝关节置换患者术后出血及膝关节功能恢复的影响

The influence of early clamping drainage pipe on postoperative bleeding and knee function of patinets with knee prosthesis

目的：探讨早期夹闭引流管对膝关节置换患者术后出血及膝关节功能恢复的影响。方法：选择我院2012年6月～2013年8月收治的膝关节骨性关节炎行膝关节置换治疗的患者60例，将其随机等分为研究组和对照组，研究组术后即刻关闭引流管4h后再持续开放引流，对照组术后持续引流，两组治疗方式及其他术后处理方式相同。观察两组患者术后48h的血红蛋白（Hb）、血细胞比容（HCT），统计两组患者总失血量、输血量、引流量，术后评价两组患者疼痛情况及膝关节功能改善情况。结果：研究组患者术后48hHb、HCT均明显高于对照组（P〈0．05），总失血量、输血量、引流量均少于对照组（P〈0．05）。两组患者术后疼痛评分、切口愈合时间、膝关节功能状态评分比较差异无统计学意义（P〉0．05）。结论：膝关节置换术后早期夹引流管能有效减少患者失血量，且对术后切口愈合及膝关节功能恢复无明显不良影响。

Objective ： To investigate the influence of early clamping drainage pipe on postoperative bleeding and knee function of patinets with knee prosthesis. Methods：60 patients who were given knee osteoarthritis replacement in our hospital from June 2012 to August 2013 were randomly divided into two groups,two groups were given the same treatment,the drainage pipe of study group was clampded for 4 hours immediately after treatment, and the control group was given continued drainage, the other treatment of two groups were same. Before and 48 hours after surgery, hemoglobin （ Hb）, hematocrit （HCT） of two groups were observed, total blood loss and drainage volume were analyzed, the pain conditions （ VAS score ） and knee function improvement （ HSS score ） of two groups were evaluted. Results：The preoperative Hb, HCT of two groups were no significantly different,48 h after surgery Hb, HCT of study group were significantly higher than control group, the difference was statistically significant （P〈0.05 ）, total blood loss and drainage volume of study group were significantly less than the control group, the difference was statistically significant （ P 〈 0.05 ）, postoperative VAS score, wound healing time, HSS score between two groups were not siguificantly different （ P 〈 0.05 ）. Conclusion ： Early clamping drainage pipe in patients with knee replacement can effectively reduce blood loss and has no significant adverse effects on postoperative wound healing and restore knee function.