人工膝关节置换术后夹闭引流管4h对术后出血的影响

Effect of clamping drainage tube for four hours on postoperative blood loss in patients underwent total knee arthroplasty

目的探讨人工膝关节置换术(TKA)后引流管夹闭4h和不夹闭对患者术后出血量的影响。方法 TKA患者60例均分为A、B两组。A组术后夹闭引流管4h后开放,B组术后不夹闭引流管。比较两组术后引流量、住院时间及术后并发症的发生率。结果 A组术后24-h引流量较B组少[(512.4±253.5)ml vs.(873.4±301.5)ml](P<0.05);A组术后接受输血治疗患者的比例低于B组(46.7%vs.90.0%)(P<0.05)。在未输血的患者中,A组术后血红蛋白的下降值低于B组[(15.5±7.2)g/L vs.(21.8±10.3)g/L](P<0.05)。两组患者术后发生切口红肿、发热及康复情况差异无统计学意义。结论 TKA术后夹闭引流管4h能有效减少患者术后出血量,不增加患者术后感染及功能恢复的风险。

Objective To observe the effect of clamping drainage tube for 4 hours on postoperative blood loss in the patients underwent total knee arthroplasty （TKA ） .Methods Sixty patients underwent TKA were equally assigned into two groups .The drainage tube in group A was clamped soon after surgery for 4 hours ,which in group B was opened all the time .The blood loss , hospital stay and complications were observed and compared between two groups .Results The postoperative blood loss in 24 hours was significantly less in group A than that in group B [（512.4 ± 253.5）ml vs .（873.4 ± 301.5） ml]（P〈0 .05） .The percentage of patients needed blood transfusion after operation was significantly lower in group A than that in group B （46.7% vs .90.0% ） （P〈0 .05） .The decrease of Hb after operation was less in group A than that in group B in the cases without blood transfution [（15.5 ± 7.2） g/L vs .（21.8 ± 10.3） g/L]（P〈0 .05） .There were no significant differences in fever ,wound healing and rehabilitation between two groups .Conclusion Clamping drainage tube for 4 hours may effectively reduce postoperative blood loss in the patients underwent TKA without increasing the risk for infection and rehabilitation .